7-2. Remove Upper Airway Obstruction in an Unconscious Child
The steps given below assume the child is conscious and lying down [paragraph 7-1b(2)] or lost consciousness while you were administering abdominal thrusts [paragraph 7-1b(1)]. If you discovered an airway obstruction while performing rescue breathing [paragraph 6-4c(2)], you will have already performed the steps given in paragraphs a through c below.
a. Call for help if you have not done so or if help has not arrived.
b. Lay the child on his back on a firm, flat surface, open his airway, and check for breathing (paragraph 6-2).
c. If the child is not breathing, attempt to administer two ventilations (paragraph 6-3). If the airway is blocked, reposition the head and attempt to administer two ventilations again.
d. If the airway is still blocked, administer modified abdominal thrusts to expel the object.
e. If the obstruction has not been expelled after five thrusts, open his mouth using jaw-tongue lift [paragraph 5-6c(3)] and look for the obstruction. If you see the obstruction, perform a finger sweep [paragraphs 5-6c(5), (6), and (7)] and remove the obstruction. Do not perform a blind finger sweep since you may push the obstruction deeper into the child's throat.
f. Attempt to administer two ventilations again (paragraph 6-3). If the airway is still blocked, perform up to five abdominal thrusts and visually check for the obstruction again. Once the obstruction is removed, perform rescue breathing or CPR (Lesson 6) as needed if the child does not begin breathing again on his own.
8-1. Indications for Early Defibrillation
Very few patients who experience sudden cardiac arrest outside of a hospital survive unless a rapid sequence of events takes place. The chain of survival (figure 8-1) is a way of describing the ideal sequence of events that can take place when such an arrest occurs.
Figure 8-1. Cardiopulmonary resuscitation chain of survival.
a. Recognition of early warning signs and immediate activation of emergency medical support. Few patients benefit from defibrillation when more than 10 minutes elapse before administration of the first shock and/or CPR is not performed in the first 2 to 3 minutes.
b. Immediate bystander CPR. Cardiopulmonary resuscitation helps prolong the time during which defibrillation can be effective.
c. Early defibrillation. This may be the most important link in the chain of survival. Rapid defibrillation has successfully resuscitated many patients with cardiac arrest from ventricular fibrillation. Figure 8-2 shows how an automated external defibrillator (AED) works.
d. Early advanced cardiac life support.
Figure 8-2. How the AED works.
|David L. Heiserman, Editor||
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Revised: June 06, 2015