before you begin you want to survey the scene and things that can make the scene unsafe if you're outside of a building that could be traffic it could be an active stab or active shooter incident if the scene is not safe you will not approach you will go ahead and call 9-1-1 from a safe distance however in our instance we're surveying the scene and everything is safe now we need to check for responsiveness so we're going to go to the victim's shoulder and we're going to say hey hey are you okay are you okay we're going to tap and we're going to shout we're just not going to shout because the person could be deaf and I really want to try to stimulate this person because I don't want to be compressent on their chest if they don't need it so I'm tapping and I'm shouting and the person is not response non-responsive at this point if you're in the hospital you can go ahead and press the code button if you're outside of a hospital system you're going to go ahead and call 9-1-1 is going to be asking you what's the emergency you have a person who's not responsive that doesn't mean that they're dead if someone's blood sugar is low if they've overdosed on drugs they would be non-responsive but you still see chest rise and fall or if you're a healthcare professional you'd still be able to feel a pulse and so in our instance where CPR we're feeling for the pulse with our index and our middle finger on um we're feeling on the Carotid artery on the side nearest us and we're watching for chest rise and fall if you're old school yes you're putting your ear to their face but I promise you that's not really necessary right now all right so two fingers Carotid pulse looking for chest rise and fall 10 seconds Max that's right you get 10 seconds to decide whether or not you need to render Aid there's a breath that's called an agonal breath it's more like a gasp there are no signs of life and the person lets out air you are to assume that this person's in Cardiac Arrest because an agonal breath is a precursor to cardiac arrest and so now online's on the phone I'm telling them that there's no breathing there's no pulse they're going to ask do I have an AED and in our case we have our trainer here so yes we have an AED we're going to start high quality CPR and it now begins with chest compressions whenever you think of ABC Airway breathing circulation you want to focus on the airway as long as the person still have a pulse but once your victim is pulseless our job is to focus on high quality chest compressions we need to circulated oxygenated blood to the brain whenever someone's heart stops the oxygen doesn't leave their system it's still there it's just not moving they have residual oxygen so your goal is to start those chest compressions quickly the new priority is c a b circulation air weight and then breathing if you think about about 10 years ago the American Heart Association came out with guidelines which said that you can just do hands-only CPR which means that you wouldn't have to put your mouth on the victim's mouth whenever the advanced professionals arrived they're usually going to come with equipment and then they can take over the breast but for our purposes today I do have a pocket mask with a one-way valve and we're going to use this to simulate our reps so here we go as far as our chest compressions are concerned whenever you're compressing on the chest what I like to say is don't compress on the throat and don't press on the very end of the breastbone that's a xiphoid process pretend the victim has a perfect nipple line and you're going to place the heel of your hand in the center of their chest yes the chest should be exposed and men if you feel uncomfortable exposing a woman's chest the Good Samaritan law is going to protect you if you are rendering Aid if you still feel uncomfortable and you have now one on the phone you've called for help we want you to start those chest compressions on top of clothing but if you do realize and you're really trying to save this person's life the reason why we expose the chest is in preparation for the AED and so we do want you to do something and there is a healthy fear of you know maybe lawsuit or litigation because you're exposed a woman's chest but that fears I hope to negate that today and to decrease it because we need for you to save a woman's life the same way you save a man's life hand placement center on the chest you would then take your shoulders and your shoulders should be aligned with your hands you're going to press straight down lock your elbows when you're compressed deeply enough which is two inches for our mannequins you're going to hear a click a human you're gonna you're gonna feel resistance and that resistance is a rib and unfortunately on the breastbone we may have to sacrifice this breast bone right now in order to get to the heart that's the body's natural protective mechanism we have the rib cage and the sternum there for a reason however if I'm trying to save someone's life and trying to compress on their heart in order to circulate blood I may have to go ahead and press deeply and depend on the size of the person okay we said two inches but the side view of that person's chest is larger because they're obese you have to bring neck chest in a third of the way so depending on the size of the person the more you may have to compress but then we have an average sized person here we're going to compress two inches four five six we're gonna do 30 compressions after 30 compressions we're then going to utilize our pocket mask which is more like a teardrop shaped the angle of the mask goes over the victim's nose we're going to press and then we're going to open up the airway with a head tilt chin lift technique so let's repeat that pocket mask angle portion Bridge of the nose press tilt and now you're going to give a breath repeat it and follow it by a second breath so after 30 compressions you give two breaths each breath should last about one second what you don't want to do is hyperinflate the chest by giving too much air because if you give a really big breath you can actually inflate their stomach and of course the victim would vomit and we don't want that happening so now I'm going to repeat this process 30 compressions followed by two breaths and now continue doing this until help arrives until I'm exhausted or into the AED arrives to the scene so let's do a couple of cycles first and then we'll utilize our AED one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen Seventeen eighteen nineteen Twenty One 22 23 24 25 26 27 28 29 30. perfect one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen Seventeen eighteen nineteen twenty one twenty two twenty three twenty four twenty five twenty six 27 28 29 30. whenever your compressing it's really important that you allow for chest recoil and what chest recoil does is whenever you compress down you circulate blood when you allow the chest to rise to its normal position you allow the hard time to fill back up with blood so if you're pressing really fast you're not allowing full chest expansion so press down let it raise and you're going to continue doing this until the scene becomes unsafe until the victims have signs of life if they do have signs of life you can turn them over into the recovery position if Health never comes and you're exhausted you can stop your efforts you know you can only do so much by yourself and then of course you've called for help so in those Advanced providers come and they're in position and they take over that would be another reason when you can stop your CPR efforts and now we have our AED the AED stands for automated external defibrillator the reason why we say external is because some patients will have their implanted defibrillators or their pacemakers and you'll know that because you'll see like an elevated area beneath their skin at this point if someone's in Cardiac Arrest don't overthink it yes you can use somebody has an implanted device you just cannot place the pads on top of that implanted device if that device was doing what it was supposed to be doing it would be shocking the person in Cardiac Arrest if the person required a shock and so the first thing you do when the AED arrives to the scene is you're going to power it on once you've powered it on you want to follow the prompts they're really user friendly and if you work in an environment that has an AED my request to you is always give people homework is I want you to take a picture of the AED find the name find the brand and then go research that on YouTube because I need for you to know how to work your company's AED in the event of an emergency and a lot of people say well we have employee health so we have the nurse and my question is what happens if it's the nurse who's in cardiac arrest so I need for you to be a responsible adult and go ahead and use the AED that's at your workplace learn how to work it not just a nurse or the healthcare professionals we're going to power this on in a few moments after we power it on it's going to tell me to apply the past in the past have an image it has a diagram on it which shows you the pad placement and with an exposed chest it is high right low left okay and so when we say low left when I talk about the stomach we'll talk about with that crease of the breast would be because that's where the strongest part of the heart is after we apply the pads peel and stick it is going to tell us to connect it you have to learn how to use your AED because some models operate differently once we connect it it is going to say analyzing heart rhythm do not touch the victim and I want you to make sure that no one's touching you're going to make sure that everybody's clear I am not preparing you to work as a as part of a multi-rescular team I want you to use this AED exactly as it states so once we clear it it analyzes it's going to let you know whether or not a shock is required and if a shock is required there's going to be a light that flashes when that light flashes you press it just make sure no one's touching first and then you go right back into your compressions because there is not a residual charge any energy that's left over that can harm you all right so we talked about it let's actually perform it all right so what's the first thing I do in aeda wraps to the scene you said power it on you're correct second thing I do is listen ing test plug-in pads connector next to if you don't know how to place the pads follow the instructions that are on the actual pad iPad plug-in connector make sure the chest is exposed and clear once my pads are placed it's flashing to let me know where to connect it at apply pads plug-in connector analyzing heart rhythm no one can touch when it's analyzing make sure no one's clear patient everybody is clear shock advised it will flash when it's time for me to press the button be clear No One Touch everybody remain clear shocked now press the orange button now the button is flashing is what I'm going to press delivered and we go right back into our chest compressions the tone that you hear that beeping is called a metronome it helps you keep the pace of your compressions so if you go too fast slow it down and go with that metronome the metronome ensures that you're allowing for chest recoil and that you're compressing between 100 up to 120 compressions per minute and if you still have your pocket mask a one-way valve after your 30 compressions you go back and give your two breaths for classroom purposes only I am turning off this AED because I don't want to talk over it it's a little bit distracting in the real world you would keep your AED on until that person reaches their final destination so let's say that you're in the daycare center and you have to use the AED you keep that AED on into the paramedics Place airs on the paramed is going to keep their AED on until the person gets to the hospital even if the person is talking to you they've regained the pulse do not take the AED pads off and don't turn the AED off because these pads are usually single use and if the person loses a post again or if they stop breathing again another shock may be required so we want you to prepare and stay ready and of course if the person does regain Consciousness don't leave them on their back because they could vomit once you've stopped your CPR efforts because the person has achieved about pulse or they're breathing you want to put them on their side in the recovery position with the AED still monitoring them and the AED is going to reanalyze every two minutes and if the person does require another shock you would lay them back down follow the prompts and when the prompts have completed you press the shock button you go back into your chest compressions all right everybody so that was a quick review for CPR and AED for an adult and children is not much different a child is from age one to puberty and so if you have a large 10 year old a 10 year old is an adult size I need you to treat him or her as an adult so let's say we actually have a child who has not yet reached puberty you're still compressing two inches or one-third this side view of their chest it is still 30 compressions followed by two breaths the difference would be the reason that a child goes into cardiac arrest more than likely it's not their heart being an abnormal Rhythm it's because something's in their Airway okay maybe they drowned or maybe they have an object in their throat so breaths are really important and you actually do want to look in their mouth before you give the breast because if you can see an object you can do a finger sweep you can also use one or two hands with a child if it's a really small child and you are okay with compressing with your one hand and you're sure that you're getting down two inches do the one-handed technique however I don't have enough upper body strength with just one hand and I want to make sure that I'm giving this child the best chance at survival so I'm still going to use two hands when I'm performing CPR on a child victim your pad placement is also the same they do have pediatric AED pads however if you only have the adult pads use the adult pads and follow the images the only difference will be is if you have a really really small child which I'll show you with our infant demonstration is you cannot allow these pads to touch and of course the small If the child is smaller the pads are going to be closer together if that's the case you put one pad on the center front of the chest and one pad in the back when in doubt who's on the phone with you that is right 911 have the dispatcher they're going to work with you and they're going to make sure that they're helping you to help save this person's life alright everybody this is Eunice Mathis with Florida training academy and if you just stay tuned for one moment we're going to go ahead and show you how to save an infant's life Hello everybody welcome back we now have our infant station set up and same as with the adults and with the children we're going to make sure our scene is safe so we're going to look left and look right make sure that there's nothing that's going to injure us if there is an unsafe scene if you can pick the baby up and take them with you by all means do so but your job is to make sure that you are safe also and now that we have an infant here the way that I check for responsiveness is I actually tap on their foot which is they're more sensitive area so I'm going to tap on this baby's foot there is no response I'm going to go ahead and call 911 from my cell phone if there's a person nearby who can help me I can point to them and say Hey you call 911 and come back and now one's going to say what's the emergency you're going to say hey there is a baby who's not responsive and they're going to ask are they breathing do they have a pulse and so you can look for chest rise and fall on the baby you can also in the baby's inner aspect of their arm if you take your index and your middle finger you can feel for the break your pulse we don't feel for a Carotid pulse or neck pulse in infants because they usually have larger heads and little necks so it's gonna be harder to determine if they have a Carotid pulse but here break your pulse there's no breathing there is no pulse you can then if you haven't called for the AED go ahead and call for the AED also if you have the press and mannequins they have a feedback device and you just want to activate it by turning the little blue button on you're going to press it that's on their diaper area you can do input compression one of two ways you can use your two fingers or if you find that hard because maybe you have arthritis you can do the two thumb and circle in hand technique and I'll show you both techniques right now the hand placement we're going to go in the center of the sternum the lower half but not on their stomach I'm gonna do 30 compressions one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen Seventeen eighteen nineteen twenty one twenty two 23 24 25 26 27 28 29 30 for an infant you be compressing one and a half inches or still one-third the side view of the chest allowing for full chest recoil and you would still be performing at least 100 up to 120 compressions per minute if you have your pocket mask in your one-way valve if you remember from the previous video that the angled portion goes towards the bridge of the baby's nose we're gonna do our head tilt chin lift and we're going to give a breath all right I gave my two breaths and now for my other technique that is also allowable I'm going to go ahead and do the two thumb and circling hand technique one two three four five six seven eight nine ten eleven twelve thirteen fourteen fifteen sixteen Seventeen eighteen nineteen twenty one twenty two 23 24 25 26 27 28 29 30. wanna administer those two breaths press tilt and I will continue doing this until help arrives and my help just arrived with the AED if you're a call from a previous video we're going to power it on apply pads to patient's bare chest we have the smaller pediatric pads but if we try to place them according to the pad images the password gonna touch and that is not allowable so we're going to place one pad s plug-in connector to the center front of the baby's chest and the second pad [Music] I'm now going to insert the connector analyzing heart rhythm make sure no one is touching the baby don't touch the everyone's staying clear shock advised charging stay clear of patient everyone remain clear don't touch [Music] your compress the orange button now I'm going to press the button that's flashing make sure you don't touch the infant while you're pressing this button shock I go right back into my chest compressions seven eight nine ten eleven twelve thirteen fourteen and you will continue 30 compressions followed by two breaths until more help arrives until you're exhausted if the scene becomes unsafe and again you can take the baby with you please do so and if you're in the hospital then of course you have your rapid response team are those Advanced professionals who can take over for classroom purposes only I'm turning off this AED because I don't want to talk over it but again in the real world you would keep this AED on and it's going to reanalyze every two minutes and you would do that until the baby actually reaches Final Destination and so again if you're in a child care center that could actually be whenever the paramedics arrive and they Place their AED on if you have any further questions my name is Eunice Mathis I would love to be your instructor I'm here in Jacksonville Florida our website is fls and Florida training.com you can leave a comment down below to everybody that's our quick review I do appreciate you I thank you for watching I thank you for being a lifesaver I really you know these skills and never have to use them versus needing to use them and never refreshing never reviewing these skills if you want to know how to help a choking victim just watch the next video alright everybody have a great day