Page 44 - Occupational Health & Safety, February 2018

DEFIBRILLATORS & CPR
a shock to the heart whenever it is needed. However, it is scarce in the market today.
When Not to Use a Defibrillator
Defibrillation is not indicated if the heart rhythm has complete- ly stopped, as in asystole, or sometimes called “flat line,” or has pulseless electrical activity (PEA). Also, defibrillation is not in- dicated if the patient is conscious or has a pulse. Inappropriately given electrical shocks can cause dangerous arrhythmias.
Now that the generalities have been discussed, let’s take a look at more specific implementation of CPR and defribillators.
CPR With Rescue Breathing for Children and Adults
When used on adult patients, CPR with rescue breathing includes both chest compressions and breaths. The rescuer should:
■ Make sure the area is safe, then tap the individual on the shoul- der and shout “Are you OK?” to ensure that the person needs help.
■ Call 911 immediately and then begin chest compressions.
■ Ask another witness to locate and retrieve an automated ex- ternal defibrillator if one is available. Follow the directions on the AED and use it as soon as it arrives.
■ Placing both hands in the middle of the chest, one on top of the other, the rescuer should press down hard and perform 30 compressions.
■ Tilt the patient’s head back, lift the chin and pinch the nose closed—cover the patient’s mouth with his or her own and blow hard until the patient’s chest rises.
■ Give two breaths, each lasting one second, and then return to chest compressions.
■ Alternate 30 compressions and two breaths until profes- sional help arrives.
CPR for children is the same as CPR for adults; however, if a child younger than eight has collapsed, do not leave the child alone until you have done CPR for about two minutes. After two minutes of care, then call 911.
CPR and AED Implementation for Pregnant Women
Two lives are at stake when a pregnant woman goes into cardiac ar- rest. By understanding the physical changes brought about by preg- nancy, you can respond appropriately to maternal emergencies.
Here is a quick reference guide to first aid modifications for the mother-to-be.
Maternal Cardiopulmonary Resuscitation (CPR)
Although most characteristics of maternal resuscitation are similar to the standard adult resuscitation, several aspects are uniquely different.
■ Call 911 (or EMS) or direct someone else to call. Tell the op- erator that there is a pregnant woman in cardiac arrest. This alerts the EMS to take specific measures, such as sending additional providers. Immediate perimortem cesarean delivery (PMCD), or resuscitative hysterotomy, should be anticipated, at the site of the cardiac arrest, within four to five minutes of the arrest.
■ Start CPR with the woman flat on her back in a supine posi- tion. A tilt of her body can significantly impact the force of the chest
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