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To combat fatigue, CPR guidelines recommend changing the person performing chest compressions every two minutes.Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression-ventilation ratio.CPR with rescue breaths
Place the heel of your hand on the centre of the person’s chest, then place the palm of your other hand on top and press down by 5 to 6cm (2 to 2.5 inches) at a steady rate of 100 to 120 compressions a minute. After every 30 chest compressions, give 2 rescue breaths.
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How often should you switch chest compressors to avoid fatigue Aha?
Change compressor every 2 minutes, or sooner if fatigued. If no advanced airway, 30:2 compression-ventilation ratio.
How often do you need to compress the chest?
CPR with rescue breaths
Place the heel of your hand on the centre of the person’s chest, then place the palm of your other hand on top and press down by 5 to 6cm (2 to 2.5 inches) at a steady rate of 100 to 120 compressions a minute. After every 30 chest compressions, give 2 rescue breaths.
How often do you switch compression providers?
The 2015 cardiopulmonary resuscitation (CPR) guidelines recommend that the chest compression providers should rotate every two minutes or sooner.
How long does chest compression last?
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes. If you can’t do mouth-to-mouth, stick with continuous compressions at a rate of approximately 100 per minute. To perform CPR on adults and older children: A=Airways – open the person’s airways (nose, mouth and throat) and check they are clear.
How often should you switch compressors to avoid fatigue?
To combat fatigue, CPR guidelines recommend changing the person performing chest compressions every two minutes. However, the process of switching compressors introduces interruptions that have been shown to substantially increase the hands-off time (no-flow ratio), so this is better avoided if possible.
How often do ribs break during CPR?
Compressing the human chest by that much, requires a significant amount of force. Giving this amount of force, we can easily understand how and why ribs may break in the process of performing CPR. Approximately 30% of patients receiving CPR suffer rib fractures or bone breaks. Those numbers may actually be higher.
Can you break ribs doing CPR?
Given this amount of force, it’s easy to understand how and why ribs may break in the process of performing CPR. The general consensus has held that approximately 30% of patients receiving CPR suffer rib fractures or breaks.
What is the ideal depth to compress to?
The answer is no deeper than 5.5 centimeters, or about two inches, in adults. Any deeper, and you could damage internal organs. Any shallower, however, and you may not be pumping blood effectively through the body.
When performing two rescue CPR How often should you switch rescuer?
The rescuers will then give compressions and breaths but should switch roles after every five cycles CPR or about every two minutes. As additional rescuers arrive, they can help with rescue breathing or use of the AED or defibrillator.
How often should you ventilate a newborn?
A ventilation rate of about 8 to 10 breaths per minute will be the equivalent of giving 1 breath about every 6 to 8 seconds. Former guidelines recommended “asynchronous” compressions and ventilations (compressions and ventilations not timed with one another) during CPR when an advanced airway is in place.
How often should you ventilate a cor?
If an adult victim with spontaneous circulation (ie, palpable pulses) requires support of ventilation, give rescue breaths at a rate of 10 to 12 breaths per minute, or about 1 breath every 5 to 6 seconds (Class IIb). Each breath should be given over 1 second regardless of whether an advanced airway is in place.
How long should a Code Blue Last?
A 2012 Lancet study highlighted that the median duration of resuscitation was 12 minutes for patients achieving the return of spontaneous circulation and 20 minutes for nonsurvivors.
How long do you do CPR before brain damage?
Time is very important when an unconscious person is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 to 6 minutes later. Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use.
How long should you try to resuscitate someone?
20 minutes is a common time frame. Vasopressin takes approximately 20 minutes to begin to cause a reaction. A rescuer would need to continue attempting resuscitation for at least that long before they would expect a result. 20 minutes would then be the minimum amount of time you would attempt resuscitation.
What is the maximum interval for pausing chest compressions?
For adults victims of OHCA without an advanced airway in place, it is reasonable to pause compressions for <10 seconds to deliver 2 breaths. In adults with OHCA, it is reasonable for rescuers to perform chest compressions at 100-120/minute.
What are the 7 steps of CPR?
What Are the Seven Steps of CPR? The seven steps of CPR (cardiopulmonary resuscitation) involve checking the scene and the person, calling 911 for assistance, opening the airway, checking for breathing, chest compressions, delivering rescue breaths, and repeating CPR steps.
At what depth should you compress the chest to perform chest compression?
Push straight down on (compress) the chest at least 2 inches (5 centimeters) but no more than 2.4 inches (6 centimeters). Use your entire body weight (not just your arms) when doing compressions. Push hard at a rate of 100 to 120 compressions a minute.
What is the chest compression ratio during CPR?
For healthcare providers and those trained: conventional CPR using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths.
how often switch chest compressors
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What is cardiopulmonary resuscitation (CPR)
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Steps before giving CPR to babies and young children
How to give CPR to babies 0-12 months
Mouth-to-mouth on babies (0-12 months)
How to give CPR to young children 1-5 years
How to give CPR to adults and older children
Can it be dangerous doing chest compressions
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Cardiopulmonary resuscitation (CPR)
What is cardiopulmonary resuscitation (CPR)?
Cardiopulmonary resuscitation (CPR) is used in an emergency if someone is not breathing normally, or their heart has stopped (cardiac arrest). This combination of techniques is used:
chest compressions
rescue breathing (mouth-to-mouth).
CPR helps keep the blood circulating and delivers oxygen to the body until specialist treatment is available. There is usually enough oxygen still in the blood to keep the brain and other organs alive supported for a few minutes, but it is not circulating unless someone does CPR.
Knowing basic emergency first aid and CPR is important – it can be life-saving. Although there is no guarantee that someone will survive from being given CPR, it does give them a chance when otherwise there would have been none.
Without CPR, it only takes a few minutes for someone’s brain to become injured due to a lack of oxygen.
When to seek help in an emergency
In an emergency situation someone’s health can deteriorate quickly. Always seek help for any of these life-threatening signs:
• severe bleeding
• difficulty breathing
• not breathing
• unconsciousness
• burns
• serious accidents or trauma.
Call triple zero (000) for an ambulance in an emergency to get medical assistance. Common emergency situations for adults and children include:
Calling triple zero (000)
Some people hesitate in calling triple zero because they don’t believe their situation qualifies as an emergency. If in doubt, call 000 – the operator will direct you to the help you need.
Emergency phone operators are trained to help you and can provide advice about what you need to do while you’re waiting for emergency services to arrive.
What to expect during your call to triple zero (000) – ambulance
When you call triple zero (000), you will be asked which service you require. Tell the operator you need an ambulance. You will then be transferred to an ambulance operator and asked for the following information:
The location you need the ambulance to respond to. If the address if known, provide this to the operator.
If the address is not known, be sure to tell the operator any additional information that may assist. This may include street or road names, parks, emergency marker details , or any other landmarks nearby.
, or any other landmarks nearby. Details of the situation and what has happened.
How many people require medical assistance.
The injured person’s age and sex.
Whether the person is conscious or breathing.
The operator will organise assistance for you while you continue talking on the phone, even though you may not hear them do this.
Answer any of the operator’s questions as this can help the paramedics prepare their response before the ambulance reaches you.
The operator may give you first aid instructions over the phone. If you can, put your phone on loudspeaker.
Do not hang up until the phone operator tells you to.
When is CPR needed?
CPR is most successful when administered as soon as possible. CPR is required when a person is:
unconscious
not breathing normally
not breathing.
A person in cardiac arrest may grunt, snort or take gasping breaths – this is not normal breathing. They still need CPR – don’t wait until they stop breathing.
Although CPR steps are the same for adults and older children, the technique for babies and young children (0-5 years) is slightly different.
DRSABCD (or ‘doctors ABCD’)
The steps involved in CPR are known as DRSABCD:
D – Danger
R – Response
S – Send for help
A – Airway
B – Breathing
C – CPR
D – Defibrillator
You may like to call it ‘doctors ABCD’ (DRS ABCD) so you can remember each step.
Steps before giving CPR to babies and young children
D= Danger – look for the source of any danger and make sure you and your child are safe. R= Response – check for a response from your child as if you are trying to wake them up. For instance, speak loudly, gently squeeze them or tickle their feet. S = Send for help if your child is not responding. Call 000 and ask for an ambulance. Don’t leave your child unattended.
The emergency services operator will guide you through CPR until the ambulance arrives.
How to give CPR to babies 0-12 months
This video is available in a version aimed at Aboriginal communities , and also in the following languages:
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
To perform CPR on infants (0-12 months):
A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth). Make sure your baby is in a neutral position (such as on their back) with their head and neck in line. Do not tilt their head back or lift their chin. B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position). If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
Lie your baby on their back. Place 2 fingers on the lower half of your baby’s breastbone (in the middle of their chest). Press down with your fingers (or palm for babies over 6 months) to about a third of the depth of their chest, then release to the rest position. This counts as one compression.
Note: You may need to use the palm of your hand instead of your fingers depending on the size of your baby.
Mouth-to-mouth on babies (0-12 months)
Make sure your baby is resting in the neutral position and that their head and neck is not tilted. Gently lift their chin – be careful not to rest your hands on their throat as this could restrict air getting into their lungs. Take a small breath and cover your baby’s nose and mouth Blow gently for about one second watching for the chest to rise. After each breath watch for your baby’s chest to fall. Place your ear and face close to your baby’s ear and nose to see if air is being expelled. If your baby’s chest is not rising, gently check again for any blockages and remove them. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
Your baby recovers (they start to move, breathe normally, cough or cry). Then put them in the recovery position (onto their side).
The ambulance arrives and the paramedics take over.
Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your baby’s life.
How to give CPR to young children 1-5 years
This video is also available in the following languages:
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
To perform CPR on children (1-5 years):
A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth). Make sure your child is in a neutral position (such as on their back). Gently tilt their head back and lift their chin. B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position). If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
Lie your child on their back. Kneel beside them. Place the heel of one hand on the lower half of your child’s breastbone (in the middle of their chest). Position yourself above your child’s chest. Keep your arm straight and press down on their chest to a third in depth, then release the pressure.
This counts as one compression.
Mouth-to-mouth on children (1-5 years)
Open your child’s airway by gently placing one hand on their forehead and the other hand on their chin to tilt their head back. Pinch the soft part of their nose closed with your index finger and thumb. With your other hand, open their mouth with your thumbs and fingers. Take a breath and place your lips over your child’s mouth. Ensure you have a good seal so no air can escape. Blow steadily for about one second, watching for the chest to rise. After each breath watch for their chest to fall. Listen and feel for signs that air is being expelled. Maintain the chin lift and tilt position – take another breath and repeat. If your child’s chest is not rising, check again for any blockages and remove them. Then keep going with mouth-to mouth, making sure their head is lifted, chin tilted. Ensure that no air is escaping. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
Your child recovers (they start to move, breathe normally, cough or talk). Then put them in the recovery position (onto their side).
The ambulance arrives and the paramedics take over.
D= Defibrillator – CPR must be continued until an automated external defibrillator (AED) becomes available, the pads are attached and the machine is turned on.
Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your child’s life.
How to give CPR to adults and older children
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
If you can’t do mouth-to-mouth, stick with continuous compressions at a rate of approximately 100 per minute.
To perform CPR on adults and older children:
A=Airways – open the person’s airways (nose, mouth and throat) and check they are clear. Remove any blockage (such as vomit, blood, food or loose teeth). Don’t spend too much time doing this – CPR is your main priority. Make sure the person is in a neutral position (such as on their back). Gently tilt their head back and lift their chin. B=Breathing – are they breathing normally? If so, gently roll them onto their side (known as the recovery position). If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to give them CPR. C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
Place the heel of one hand on the lower half of the person’s breastbone (in the middle of their chest).
Place your other hand on top of your bottom hand and grasp your wrist. Or you may like to interlock your fingers – depending on what feels comfortable. Keep your arms straight and press down on their chest by one third of their chest depth. Release the pressure – this counts as one compression.
Popular tunes can help keep the rhythm of compressions
To keep the correct rhythm of compressions, you may like to use these popular songs:
‘Staying alive’ by the Bee Gees
‘Row, row, row, your boat’
‘Baby shark’.
Mouth-to-mouth on adults and older children
If the person is not breathing normally, make sure they are lying on their back on a firm surface. Open the airway by tilting the head back and lifting their chin. Close their nostrils with your finger and thumb. Put your mouth over the person’s mouth and blow into their mouth. Make sure no air is leaking. Give 2 full breaths to the person (this is called ‘rescue breathing’). Check their chest is rising and falling. If this is not happening, tilt their head back, pinch their nostrils tightly and seal your mouth to theirs. If still no luck, check their airway for any obstruction. If you cannot get air into their lungs, go back to chest compressions – this may help shift an obstruction. Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
The person becomes responsive. They may begin to move, breathe normally, cough or talk. Then put them in the recovery position (onto their side).
The ambulance arrives and the paramedics take over.
CPR can be tiring. If you need a break, ask someone else to assist with minimal disruption. Rotate the person performing compressions every 2 minutes.
If you find mouth-to-mouth difficult, continue with chest compressions until medical help arrives. They can still save someone’s life.
Can it be dangerous doing chest compressions?
Sometimes, people will have their ribs broken by chest compressions. This is still better than the alternative of not receiving CPR.
If this occurs, pause and reposition your hands before continuing or get someone else to take over.
Automated external defibrillators (AED)
D= Defibrillator – A defibrillator is a life-saving device that treats someone who is having a cardiac arrest. It can analyse abnormal heart rhythms and send an electric shock or pulse to get the heart to return to its normal pumping rhythm.
CPR must be continued until an automated external defibrillator (AED) becomes available. The pads must be attached to the skin and the machine turned on.
AEDs are easy to use – voice prompts tell you what to do.
There are different types of AEDs and some are available in public places (such as shopping centres and schools).
It is important to follow the prompts on the AED. Do not touch the person during analysis or shock delivery.
Consider a first aid course to learn CPR and basic skills
If there is an emergency, knowing simple first aid can mean the difference between life and death. Consider taking a first aid course. CPR can be life-saving first aid – it increases someone’s chances of survival until an ambulance arrives.
First aid training courses are available across Australia. A course typically takes a couple of hours and can be taken online or in person. Times are also flexible.
Participants learn basic first aid skills (including CPR) and usually receive a certificate. Follow up refresher courses are recommended every 3 years.
Many organisations hold regular courses, ask your doctor or maternal and child health nurse for more information.
Where to get help
(ACLS) Two-Rescuer Adult BLS/CPR
Many times there will be a second person available that can act as a rescuer. The ILCOR emphasizes that cell phones are available everywhere now and most have a built-in speakerphone. Direct the second rescuer to call 911/EMS without leaving the person while you begin CPR. This second rescuer can also find an AED while you stay with the person. When the second rescuer returns, the CPR tasks can be shared:
The second rescuer prepares the AED for use. You begin chest compressions and count the compressions out loud. The second rescuer applies the AED pads. The second rescuer opens the person’s airway and gives rescue breaths. Switch roles after every five cycles of compressions and breaths. One cycle consists of 30 compressions and two breaths for adults. Be sure that between each compression you completely stop pressing on the chest and allow the chest wall to return to its natural position. Leaning or resting on the chest between compressions can keep the heart from refilling in between each compression and make CPR less effective. Rescuers who become tired may tend to lean on the chest more during compressions; switching roles helps rescuers perform high-quality compressions. Quickly switch between roles to minimize interruptions in delivering chest compressions. When the AED is connected, minimize interruptions of CPR by switching rescuers while the AED analyzes the heart rhythm. If a shock is indicated, minimize interruptions in CPR by resuming CPR as soon as possible beginning with chest compressions.
Frequently Asked Questions about Chest-Compression-Only CPR
How do you know if it’s primary cardiac arrest?
The person is fine one moment and you suddenly see or hear them collapse.
You then check for responsiveness by “shaking and shouting” (are you alright?) and rub the sternum with your knuckles. This helps to determine whether the person had some other reason for the event or if they are indeed in cardiac arrest. If you have no response you should assume that the person has experienced cardiac arrest.
Tell someone to call 911 or make the call yourself. You need to get emergency responders on their way as soon as possible.
Start chest compressions.
Just do your best. If you do nothing, the person is likely to die. Studies have shown that there is almost no chance that you will hurt the person. While it is rare that a rib will be broken during CPR, doctors are able to repair broken ribs, but they cannot repair death.
Is this the same as a heart attack?
No. In the case of a heart attack, blood flow through one of the coronary arteries becomes blocked. Remember, time is heart muscle. To preserve heart muscle, it’s important to understand early heart attack symptoms:
Chest discomfort. The discomfort lasts for more than a few minutes or it may go away and come back. The discomfort may feel like pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body. This may include pain or discomfort in one or both arms, the back, neck, jaw, or upper stomach.
Shortness of breath may occur with or before chest discomfort.
Other symptoms may include breaking out in a cold sweat, nausea, dizziness or light-headedness, “feeling of impending doom,” weakness/fatigue.
Women are different than men and not all symptoms of a heart attack are universal. Please check the following for more information:
https://heart.arizona.edu/heart-health/heart-attacks/women-symptoms
https://heart.arizona.edu/heart-health/heart-attacks/do-you-know-what-heart-attack-looks
If this happens to you or you witness someone who exhibits these signs: call 911.
Should I stop compressions if the victim gasps?
No! Gasping is a sign of cardiac arrest and often occurs for a while soon after the arrest and will continue when effective compressions are being delivered. It is NOT an indication of recovery. Continue chest compressions until paramedics arrive; gasping is a sign you are doing a good job.
What if I get tired during chest compressions?
Chest compressions are hard work and after 100 chest compressions or if you become fatigued, it is recommended that you switch chest comrpessions with someone nearby. To transfer chest compressions effectively, there must be less than a 10 second delay when trading off.
Can you damage someone’s heart if you perform CPR while it is beating?
The physicians and scientists at the Sarver Heart Center, have found that the old saying “Never perform CPR on beating heart” is not valid. According to these professionals, the chances that a bystander could harm a person by pressing on their chest are slim to none, even if the heart is working normally. Therefore, they recommend following the “Better safe than sorry” approach and begin chest compressions. It is better to perform a few unnecessary chest compressions for someone with a beating heart, rather than withhold chest compressions and circulation from someone in cardiac arrest.
Why don’t you check for a pulse?
We do NOT recommend that lay public rescuers waste time trying to assess for a palpable pulse. During Dr. Kern’s tenure as AHA National ACLS Chairman, the AHA came to the same conclusion. Public lay rescuers cannot reliably detect the absence of a pulse in a timely fashion, hence in the 2000 and 2005 AHA CPR Guidelines (Circulation 2005; 112(24): IV-3), this requirement was removed.
Studies have also shown that even if a person manages to locate the correct spot for detecting a pulse, there is a high chance that the pulse they may detect is their own, especially considering heightened stress levels in such situations. Rather than wasting time trying to detect a pulse that may or may not be the victim’s own pulse, it is better to get perfusion to the brain by continuous chest compressions.
The correct response to a witnessed cardiac arrest is to:
Check for responsiveness (shake and shout).
IF NO RESPONSE, call for help (“911”) or ask someone else to call.
Begin uninterrupted forceful continuous chest compressions immediately.
Call for an AED if one is nearby and available.
Don’t you need to check the airway first?
If you see or hear someone suddenly collapse and they did not show any sign of choking, you don’t have to worry about checking the airway. Assume it’s a sudden cardiac arrest and follow the 3 Cs: Check for responsiveness (shake and shout), Call 911 and Compress at a rate of 100 per minute, about 2 inches deep. If by some chance an object is lodged in the throat, effective compressions likely will dislodge the object, similarly to the way abdominal thrusts (the Heimlich Maneuver) dislodges objects.
Do I have to remove a person’s clothes to do Chest-Compression-Only CPR or only when using an AED?
It is not necessary to remove a patient’s clothing in order to do chest-compression-only CPR. However, if an AED is available, turn on the device and follow the instructions, which state to “remove patient’s clothing.” Defibrillator pads must be placed directly on the patient’s skin in order for the electrical current to be conducted.
How does the victim get oxygen with Chest-Compression-Only CPR?
When someone’s heart has stopped, blood is no longer circulated through the body and therefore hardly any of the oxygen in the blood is used. The person was breathing normally only seconds ago, so their blood contains enough oxygen to tide them over for several minutes. However, it is crucial to deliver blood and oxygen to the brain by performing chest compressions continuously.
Remember: Your hands become their heart and each chest compression becomes their heart beat. Performing adequate chest compressions also increases the likelihood that the patient will gasp or continue to gasp, allowing the lungs to obtain fresh oxygen.
What if the person has an ICD or a pacemaker?
Fortunately, the answer is short and simple: Don’t worry about it. If the person in cardiac arrest has an ICD, the ICD is not functioning properly, since its purpose is to PREVENT cardiac arrest from happening. Pacemakers have a different function, but the answer remains the same, continuous chest compressions should be performed. It is important to recognize that someone in cardiac arrest is either dead or will be dead unless you intervene.
What if the person recently underwent open heart surgery, couldn’t this crack the chest bone?
The key message here is that you cannot do more damage. It is important to recognize that someone in cardiac arrest is dying or will soon be dead unless you intervene. Since this person’s heart is no longer functioning properly on its own, your compressions are doing the heart’s job. Yes, if the person has had recent surgery, you might break the wires in their breast bone. However, the alternative is death.
Can I be held liable for performing Chest-Compression Only CPR?
The Good Samaritan law protects bystanders and their actions when they decide to help someone in an emergency. There is some form of the Good Samaritan Law in all states of the U.S. Chest-Compression-Only CPR and conventional CPR are both covered under the Good Samaritan Law. It does not matter whether you are certified or not but remember to always respect the patient.
Will chest compressions alone bring the person back or restart the heart?
It is highly unlikely that chest compressions alone will result in recovery. However, by maintaining uninterrupted chest compressions, you can dramatically increase the chance of survival by maintaining the patient’s heart in a state that increase the likelihood that shocks from a defibrillator, administered through bystanders using an Automated External Defibrillator (AED), or administered by paramedics will result in survival.
Can this method be used in all arrests?
For unresponsiveness in young children (age 8 or under), drowning cases, or drug overdoses, follow conventional CPR guidelines (30 chest compressions followed by two mouth-to-mouth ventilations). This is because in infants or children, respiratory arrest is more common than primary cardiac arrest. However, even in these cases, Chest-Compression-Only CPR is better than doing nothing. To learn conventional CPR, a certification class is recommended.
Approved by Sarver Heart Center Resuscitation Research Group
For more information visit:
www.heart.arizona.edu or www.AZshare.gov
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