Adult Chest Compressions

Chest compressions on an adult require you to place both of your hands directly over the lower half of the victim’s breastbone. You will need to lock your arms and push down two inches. You will then release all of the pressure off of the victim’s chest. This should be performed 100 to 120 times per minute.

Note: It is important to make sure you are not resting on the chest between compressions because that will prevent the heart from fully refilling with blood.

Adult Rescue Breathing

Rescue breathing for an adult will allow you to replace depleted oxygen in the victim’s blood. Three options of rescue breathing exist: mouth-to-mouth, mouth-to-mask, and bag-valve-mask. With either technique, you will want to provide two breaths stopping once you notice chest rise for every thirty chest compressions.

For every 30 compressions perform 2 rescue breaths.

Adult Mouth-to-Mouth

  • Pinch the victims nose closed

  • Tilt their head back

  • Place your mouth over their mouth forming a seal

  • Exhale one breath over one second into their mouth watching for chest rise and stopping when you see the chest rise

  • Remove your mouth allowing the victim to exhale over one second

  • Exhale one more breath into their mouth watching for chest rise and stopping when you see the chest rise

Adult Mouth-to-Mask

  • Place the mask over the victims mouth and nose

  • Tilt their head back

  • Form a seal around the mouthpiece with your mouth

  • Exhale one breath over one second into their mouth watching for chest rise and stopping when you see the chest rise

  • Remove your mouth allowing the victim to exhale over one second

  • Exhale one more breath into their mouth watching for chest rise and stopping when you see the chest rise

Adult Bag-Valve-Mask (BVM)

  • Place the mask over the victim’s nose and mouth with your thumb and index finder with enough pressure to form a tight mask seal

  • Tilt the victims head back while keeping a tight mask seal

  • Deliver one breath over one second (stopping when you note chest rise)

  • Release the bag for one second allowing the victim to exhale

  • Deliver one more breath over one second (stopping when you note chest rise)

Adult AED

AED’s are to be implemented immediately upon availability during your chest compressions and rescue breaths. The person delivering the AED should be directed to work around the chest compressor to deploy the AED.

Some cardiac arrests are caused by disorganized electrical activity within the heart. In these specific cases, resetting the electrical system of the heart can restore organized and coordinated electrical activity restoring the circulation of blood. The AED is able to determine these types of cardiac arrest, and restart the heart by sending a large impulse of electricity through the heart.

To operate an AED follow these three steps:

  • Turn AED On

  • Place Pads on Victim

  • Follow AED Prompts

Make sure to avoid touching the patient while the AED is analyzing and during shock delivery.

For an adult patient, place one pad on the right chest as pictured and place the other pad below the left armpit. Make sure to avoid placing the pads on breast tissue, over clothing, over medical patches, or over bulges in the skin.

Adult Team CPR

If you have multiple rescuers one person should establish themselves as a team coach. The role of the team coach is to ensure all important steps are being taken effectively and to promote effective communication. An effective team coach will:

  • Identify and designate a person to activate 911 and ensure responders have access to the area

  • Identify and designate a person to perform chest compressions and switch them every two minutes

  • Provide encouragement and coaching to the chest compressor if/when necessary

  • Identify and designate a person to retrieve the closest AED and deploy it

All of the steps of CPR need to be performed and having a team with a team coach allows a resuscitation to happen quicker and with greater efficiency.

Adult Choking

Adults may choke for any number of reasons. It is important to quickly identify a choking adult and respond appropriately. A choking adult may or may not appear in distress as the first few moments can be filled with confusion and panic.

You will need to determine if the victim has a complete airway obstruction or a partial airway obstruction. Is their airway completely blocked preventing any airflow or is it just partially blocked allowing some airflow. For a victim with a complete airway obstruction you will want to attempt to dislodge the object and relieve the choking. Victims with partial obstructions that are able to move air and speak should be monitored until first responders arrive.

Do not forget to introduce yourself and obtain permission to intervene.

Complete Obstruction

  • No ability to speak

  • No ability to scream

  • No ability to breath

  • Attempt Choking Relief and Call 911

Partial Obstruction

  • May be able to speak

  • May be able to scream/screech

  • May be able to move some air

  • Call 911 and Monitor

Adult choking relief may be performed with one of two methods: abdominal thrusts or chest thrusts. The most effective and ideal technique is abdominal thrusts, but requires you to be able to wrap your arms around the patient’s abdomen. In cases where this is not possible and pregnancy opt for chest thrusts.

If choking relief fails and the person becomes unresponsive, start CPR.

Adult Abdominal Thrusts

To properly perform abdominal thrusts wrap both hands around the abdomen just above the belly button. Form one hand into a fist with your thumb facing up and into their abdomen and your second hand wrapped around your fist. Pull in firmly and brisk repeatedly until the object becomes dislodged.

Adult Chest Thrusts

Chest thrusts should only be performed on pregnant people or people you are unable to effectively wrap your arms around their abdomen.

To properly perform chest thrusts wrap both hands around the chest under their armpits and your hands over the lower half of their breastbone. Form one hand into a fist with your thumb facing into their chest and your second hand wrapped around your fist. Pull in frimley and brisk repeatedly until the object becomes dislodged.

Review

Where do you place your hands in adult CPR?

How deep do you compress in adult CPR?

How many times in one minute do you compress in adult CPR?

How many compressions are performed before delivering two breaths in adult CPR?

What is a team coach?

What should you do if a choking person becomes unresponsive?