FITT 7 First Aid and Water Survival

CHAPTER 2
CARDIAC EMERGENCIES AND CPR

LESSON OBJECTIVES
- Recognize the signals of a cardiac emergency.
- Identify the links in the Cardiac Chain of Survival.
- Describe how to care for a heart attack.
- List the causes of cardiac arrest.
- Explain the role of CPR in cardiac arrest.
- Demonstrate how to perform CPR
INTRODUCTION
Cardiac emergencies are life threatening. Heart attack and cardiac arrest are major causes of
illness and death in the United States. Every day in U.S. homes, parks and workplaces someone
will have a heart attack or go into cardiac arrest. Recognizing the signals of a heart attack and
cardiac arrest, calling 9-1-1 or the local emergency number and giving immediate care in a cardiac
emergency saves lives. Performing CPR and using an automated external defibrillator (AED)
immediately after a person goes into cardiac arrest can greatly increase his or her chance of
survival.
In this chapter you will find out what signals to look for if you suspect a person is having a heart
attack or has gone into cardiac arrest. This chapter also discusses how to care for a person having
a heart attack and how to perform CPR for a person in cardiac arrest. In addition, this chapter
covers the important links in the Cardiac Chain of Survival.
Although cardiac emergencies occur more commonly in adults, they also occur in infants and
children. This chapter discusses the causes of cardiac arrest and how to provide care for all age
groups.
BACKGROUND
The heart is a fascinating organ. It beats more than 3 billion times in an average lifetime.
The heart is about the size of a fist and lies between the lungs in the middle of the chest. It pumps
blood throughout the body. The ribs, breastbone and spine protect it from injury. The heart is
separated into right and left halves.
Blood that contains little or no oxygen enters the right side of the heart and is pumped to the
lungs. The blood picks up oxygen in the lungs when you breathe. The oxygen-rich blood then goes
to the left side of the heart and is pumped from the heart’s blood vessels, called the arteries, to all
other parts of the body. The heart and your body’s vital organs need this constant supply of
oxygen-rich blood.
Cardiovascular disease is an abnormal condition that affects the heart and blood vessels.
An estimated 80 million Americans suffer from some form of the disease. It remains the number
one killer in the United States and is a major cause of disability. The most common conditions
caused by cardiovascular disease include coronary heart disease, also known as coronary artery
disease, and stroke, also called a brain attack.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

Coronary heart disease occurs when the arteries that supply blood to the heart muscle harden and
narrow. This process is called atherosclerosis. The damage occurs gradually, as cholesterol and
fatty deposits called plaque build-up on the inner artery walls. As this build-up worsens, the
arteries become narrower. This reduces the amount of blood that can flow through them and
prevents the heart from getting the blood and oxygen it needs. If the heart does not get blood
containing oxygen, it will not work properly. Coronary heart disease accounts for about half of the
greater than 800,000 adults who die each year from cardiovascular disease.
When the heart is working normally, it beats evenly and easily, with a steady rhythm. When
damage to the heart causes it to stop working effectively, a person can experience a heart attack
or other damage to the heart muscle. A heart attack can cause the heart to beat in an irregular
way. This may prevent blood from circulating effectively.
When the heart does not work properly, normal breathing can be disrupted or stopped. A heart
attack also can cause the heart to stop beating entirely. This condition is called cardiac arrest.
The number one cause of heart attack and cardiac arrest in adults is coronary heart disease. Other
significant causes of cardiac arrest are non-heart related (e.g., poisoning or drowning).
HEART ATTACK
When blood flow to the heart muscle is reduced, people experience chest pain. This reduced blood
flow usually is caused by coronary heart disease. When the blood and oxygen supply to the heart
is reduced, a heart attack may result.
What to Look For?
A heart attack can be indicated by common signals. Even people who have had a heart attack
may not recognize the signals, because each heart attack may not show the same signals. You
should be able to recognize the following signals of a heart attack so that you can give prompt and
proper care:
▪ Chest pain, discomfort or pressure. The most common signal is persistent pain, discomfort
or pressure in the chest that lasts longer than 3 to 5 minutes or goes away and comes back.
Unfortunately, it is not always easy to distinguish heart attack pain from the pain of
indigestion, muscle spasms or other conditions. This often causes people to delay getting
medical care. Brief, stabbing pain or pain that gets worse when you bend or breathe deeply
usually is not caused by a heart problem.
o The pain associated with a heart attack can range from discomfort to an unbearable
crushing sensation in the chest.
o The person may describe it as pressure, squeezing, tightness, aching or heaviness in
the chest.
o Many heart attacks start slowly as mild pain or discomfort.
o Often the person feels pain or discomfort in the center of the chest (Fig. 2-3).
o The pain or discomfort becomes constant. It usually is not relieved by resting,
changing position or taking medicine.
o Some individuals may show no signals at all.

▪ Discomfort in other areas of the upper body in addition to the chest. Discomfort, pain or
pressure may also be felt in or spread to the shoulder, arm, neck, jaw, stomach or back.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

▪ Trouble breathing. Another signal of a heart attack is trouble breathing. The person may be
breathing faster than normal because the body tries to get the much-needed oxygen to the
heart. The person may have noisy breathing or shortness of breath.

▪ Other signals. The person’s skin may be pale or ashen (gray), especially around the face.
Some people suffering from a heart attack may be damp with sweat or may sweat heavily, feel
dizzy, become nauseous or vomit. They may become fatigued, lightheaded or lose
consciousness. These signals are caused by the stress put on the body when the heart does
not work as it should. Some individuals may show no signals at all.

▪ Differences in signals between men and women. Both men and women experience the
most common signal for a heart attack: chest pain or discomfort. However, it is important to
note that women are somewhat more likely to experience some of the other warning signals,
particularly shortness of breath, nausea or vomiting, back or jaw pain and unexplained fatigue
or malaise. When they do experience chest pain, women may have a greater tendency to
have atypical chest pain: sudden, sharp but short-lived pain outside of the breastbone.
When to Call 9-1-1?
Remember, the key signal of a heart attack is persistent chest pain or discomfort that lasts
more than 3 to 5 minutes or goes away and comes back. If you suspect the person is having a
heart attack based on his or her signals, call 9-1-1 or the local emergency number immediately. A
person having a heart attack probably will deny that any signal is serious. Do not let this influence
you. If you think the person might be having a heart attack, act quickly.
What to Do Until Help Arrives?
It is important to recognize the signals of a heart attack and to act on those signals. Any
heart attack might lead to cardiac arrest, but prompt action may prevent further damage to the
heart. A person suffering from a heart attack, and whose heart is still beating, has a far better
chance of living than does a person whose heart has stopped. Most people who die of a heart
attack die within 2 hours of the first signal. Many could have been saved if people on the scene or
the person having the heart attack had been aware of the signals and acted promptly.
Many people who have heart attacks delay seeking care. Nearly half of all heart attack victims
wait for 2 hours or more before going to the hospital. Often, they do not realize they are having a
heart attack. They may say the signals are just muscle soreness, indigestion or heartburn.
Early treatment with certain medications—including aspirin—can help minimize damage to the
heart after a heart attack. To be most effective, these medications need to be given within 1 hour
of the start of heart attack signals.
If you suspect that someone might be having a heart attack, you should:
▪ Call 9-1-1 or the local emergency number immediately.
▪ Have the person stop what he or she is doing and rest comfortably (Fig. 2-4).
▪ This will ease the heart’s need for oxygen. Many people experiencing a heart attack
find it easier to breathe while sitting.
▪ Loosen any tight or uncomfortable clothing.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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▪ Closely watch the person until advanced medical personnel take over. Notice any
changes in the person’s appearance or behavior. Monitor the person’s condition.
▪ Be prepared to perform CPR and use an AED, if available, if the person loses
consciousness and stops breathing. Ask the person if he or she has a history of
heart disease. Some people with heart disease take prescribed medication for chest
pain. You can help by getting the medication for the person and assisting him or her
with taking the prescribed medication.
▪ Offer aspirin, if medically appropriate and local protocols allow, and if the patient
can swallow and has no known contraindications (see the following section). Be
sure that the person has not been told by his or her health care provider to avoid
taking aspirin.
▪ Be calm and reassuring. Comforting the person helps to reduce anxiety and eases
some of the discomfort.
▪ Talk to bystanders and if possible, the person to get more information.
▪ Do not try to drive the person to the hospital yourself. He or she could quickly get
worse on the way.
Giving Aspirin to Lessen Heart Attack Damage
You may be able to help a conscious person who is showing early signals of a heart attack
by offering him or her an appropriate dose of aspirin when the signals first begin. However, you
should never delay calling 9-1-1 or the local emergency number to do this. Always call for help as
soon as you recognize the signals of a heart attack. Then help the person to be comfortable
before you give the aspirin.
If the person is able to take medicine by mouth, ask:
▪ Are you allergic to aspirin?
▪ Do you have a stomach ulcer or stomach disease?
▪ Are you taking any blood thinners, such as warfarin (Coumadin™)?
▪ Have you ever been told by a doctor to avoid taking aspirin?
If the person answers no to all of these questions, you may offer him or her two chewable
(81 mg each) baby aspirins, or one 5-grain (325 mg) adult aspirin tablet with a small amount of
water. Do not use coated aspirin products or products meant for multiple uses such as for cold,
fever and headache. You also may offer these doses of aspirin if the person regains
consciousness while you are giving care and is able to take the aspirin by mouth.
Be sure that you offer only aspirin and not Tylenol®, acetaminophen or nonsteroidal anti-
inflamatory drugs (NSAIDs), such as ibuprofen, Motrin®, Advil®, naproxen and Aleve®.
CARDIAC ARREST
Cardiac arrest occurs when the heart stops beating or beats too ineffectively to circulate
blood to the brain and other vital organs. The beats, or contractions, of the heart become
ineffective if they are weak, irregular or uncoordinated, because at that point the blood no longer
flows through the arteries to the rest of the body.
When the heart stops beating properly, the body cannot survive. Breathing will soon stop,
and the body’s organs will no longer receive the oxygen they need to function. Without oxygen,

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

brain damage can begin in about 4 to 6 minutes, and the damage can become irreversible after
about 10 minutes.
A person in cardiac arrest is unconscious, not breathing and has no heartbeat. The heart
has either stopped beating or is beating weakly and irregularly so that a pulse cannot be
detected.
Cardiovascular disease is the primary cause of cardiac arrest in adults. Cardiac arrest also
results from drowning, choking, drug abuse, severe injury, brain damage and electrocution.
Causes of cardiac arrest in children and infants include airway and breathing problems, traumatic
injury, a hard blow to the chest, congenital heart disease and sudden infant death syndrome
(SIDS).
Cardiac arrest can happen suddenly, without any of the warning signs usually seen in a
heart attack. This is known as sudden cardiac arrest or sudden cardiac death and accounts
for more than 300,000 deaths annually in the United States. Sudden cardiac arrest is caused by
abnormal, chaotic electrical activity of the heart (known as arrhythmias). The most common life-
threatening abnormal arrhythmia is ventricular fibrillation (V-fi b).
CARDIAC CHAIN OF SURVIVAL
CPR alone may not be enough to help someone survive cardiac arrest. Advanced medical
care is needed as soon as possible. A person in cardiac arrest will have the greatest chance of
survival if you follow the four links in the Cardiac Chain of Survival:
1. Early recognition and early access to the emergency medical services (EMS) system.
The sooner someone calls 9-1-1 or the local emergency number, the sooner EMS personnel
will take over.
2. Early CPR. CPR helps supply blood containing oxygen to the brain and other vital organs.
This helps to keep the person alive until an AED is used or advanced medical care is
provided.
3. Early defibrillation. An electrical shock, called defibrillation, may help to restore an
effective heart rhythm.
4. Early advanced medical care. EMS personnel provide more advanced medical care and
transport the person to a hospital.
For each minute that CPR and defibrillation are delayed, the chance for survival is reduced by
about 10 percent.
In the Cardiac Chain of Survival, each link of the chain depends on, and is connected to,
the other links. Taking quick action by calling 9-1-1 or the local emergency number, starting
CPR immediately and using an AED, if one is available, makes it more likely that a person in
cardiac arrest will survive. Remember, you are the first link in the Cardiac Chain of Survival. By
acting quickly, you can make a positive difference for someone experiencing a cardiac
emergency.
What to Look For?
The main signals of cardiac arrest in an adult, a child and an infant are unconsciousness
and no breathing.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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The presence of these signals means that no blood and oxygen are reaching the person’s
brain and other vital organs.
When to Call 9-1-1
Call 9-1-1 or the local emergency number immediately if you suspect that a person is in
cardiac arrest or you witness someone suddenly collapse.
What to Do Until Help Arrives
Perform CPR until an AED is available and ready to use or advanced medical personnel
take over.
Early CPR and Defibrillation A person in cardiac arrest needs immediate CPR and
defibrillation. The cells of the brain and other important organs continue to live for a short time—
until all of the oxygen in the blood is used.
Cardio Pulmonary Resuscitation (CPR)
A combination of chest compressions and rescue breaths. When the heart is not beating,
chest compressions are needed to circulate blood containing oxygen. Given together, rescue
breaths and chest compressions help to take over for the heart and lungs. CPR increases the
chances of survival for a person in cardiac arrest.
In many cases, however, CPR alone cannot correct the underlying heart problem:
defibrillation delivered by an AED is needed. This shock disrupts the heart’s electrical activity
long enough to allow the heart to spontaneously develop an effective rhythm on its own. Without
early CPR and early defibrillation, the chances of survival are greatly reduced. (Using an AED is
discussed in detail in Chapter 3.)
CPR FOR ADULTS
To determine if an unconscious adult needs CPR, follow the emergency action steps
(CHECK—CALL—CARE) that you learned in Chapter 1.
CHECK ■ the scene and the injured or ill person.
CALL ■ 9-1-1 or the local emergency number.
CHECK ■ for breathing for no more than 10 seconds. Quickly
■ CHECK for severe bleeding. (If the person is not breathing)
■ CARE by beginning CPR. For chest compressions to be the most effective, the person should be
on his or her back on a firm, flat surface. If the person is on a soft surface like a sofa or bed, quickly
move him or her to a firm, flat surface before you begin.
To perform CPR on an adult:

• Position your body correctly by kneeling beside the person’s upper chest, placing your
hands in the correct position, and keeping your arms and elbows as straight as possible so
that your shoulders are directly over your hands. Your body position is important when

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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giving chest compressions. Compressing the person’s chest straight down will help you
reach the necessary depth. Using the correct body position also will be less tiring for you.

• Locate the correct hand position by placing the heel of one hand on the person’s sternum
(breastbone) at the center of his or her chest. Place your other hand directly on top of the
first hand and try to keep your fingers off of the chest by interlacing them or holding them
upward. If you feel the notch at the end of the sternum, move your hands slightly toward the
person’s head. If you have arthritis in your hands, you can give compressions by grasping
the wrist of the hand positioned on the chest with your other hand. The person’s clothing
should not interfere with finding the proper hand position or your ability to give effective
compressions. If it does, loosen or remove enough clothing to allow deep compressions in
the center of the person’s chest.

• Give 30 chest compressions. Push hard, push fast at a rate of at least 100 compressions
per minute. Note that the term “100 compressions per minute” refers to the speed of
compressions, not the number of compressions given in a minute. As you give
compressions, count out loud, “One and two and three and four and five and six and…” up
to 30. Push down as you say the number and come up as you say “and.”, This will help you
to keep a steady, even rhythm.

• Give compressions by pushing the sternum down at least 2 inches. The downward and
upward movement should be smooth, not jerky. Push straight down with the weight of your
upper body, not with your arm muscles. This way, the weight of your upper body will create
the force needed to compress the chest. Do not rock back and forth. Rocking results in less-
effective compressions and wastes much needed energy. If your arms and shoulders tire
quickly, you are not using the correct body position. After each compression, release the
pressure on the chest without removing your hands or changing hand position. Allow the
chest to return to its normal position before starting the next compression. Maintain a steady
down-and-up rhythm and do not pause between compressions. Spend half of the time
pushing down and half of the time coming up. When you press down, the walls of the heart
squeeze together, forcing the blood to empty out of the heart. When you come up, you
should release all pressure on the chest, but do not take hands off the chest. This allows the
heart’s chambers to fill with blood between compressions.

• Once you have given 30 compressions, open the airway using the head-tilt/chin-lift
technique and give 2 rescue breaths. Each rescue breath should last about 1 second and
make the chest clearly rise.

o Open the airway and give rescue breaths, one after the other.
o Tilt the head back and lift the chin up.
o Pinch the nose shut then make a complete seal over the person’s mouth.
o Blow in for about 1 second to make the chest clearly rise.
o Continue cycles of chest compressions and rescue breaths.
o Each cycle of chest compressions and rescue breaths should take about 24
seconds. Minimize the interruption of chest compressions.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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If Two Responders Are Available

If two responders trained in CPR are at the scene, both should identify themselves as being
trained. One should call 9-1-1 or the local emergency number for help while the other performs CPR.
If the first responder is tired and needs help:
▪ The first responder should tell the second responder to take over.
▪ The second responder should immediately take over CPR, beginning with chest
compressions.
When to Stop CPR
Once you begin CPR, do not stop except in one of these situations:
▪ You notice an obvious sign of life, such as breathing.
▪ An AED is available and ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.
If at any time you notice that the person is breathing, stop CPR. Keep his or her airway open
and continue to monitor the person’s breathing and for any changes in the person’s condition until
EMS personnel take over.
CARDIAC EMERGENCIES IN CHILDREN AND INFANTS
It is rare for a child or an infant to initially suffer a cardiac emergency. Usually, a child or an
infant has a respiratory emergency first and then a cardiac emergency develops.
Causes of cardiac arrest in children and infants include:
▪ Airway and breathing problems.
▪ Traumatic injury or an accident (e.g., motor-vehicle collision, drowning, electrocution
or poisoning).
▪ A hard blow to the chest.
▪ Congenital heart disease.
▪ Sudden infant death syndrome (SIDS).
▪ If you recognize that a child or an infant is not breathing, begin CPR.
CPR FOR CHILDREN AND INFANTS
Follow the emergency action steps (CHECK— CALL—CARE) to determine if you will need to
perform CPR for a child or an infant. The principles of CPR (compressing the chest and giving
rescue breaths) are the same for children and infants as for adults. However, the CPR techniques
are slightly different since children’s and infants’ bodies are smaller.
CPR FOR A CHILD
If during the unconscious check you find that the child is not breathing, place the child face-up
on a firm, flat surface. Begin CPR by following these steps:
▪ Locate the proper hand position on the middle of the breastbone as you would for
an adult. If you feel the notch at the end of the sternum, move your hands slightly
toward the child’s head.
Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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▪ Position your body as you would for an adult, kneeling next to the child’s upper
chest, positioning your shoulders over your hands and keeping your arms and
elbows as straight as possible.
▪ Give 30 chest compressions. Push hard, push fast to a depth of about 2 inches and
at a rate of at least 100 compressions per minute. Lift up, allowing the chest to fully
return to its normal position, but keep contact with the chest.
▪ After giving 30 chest compressions, open the airway and give 2 rescue breaths.
Each rescue breath should last about 1 second and make the chest clearly rise.
Use the head-tilt/chin-lift technique to ensure that the child’s airway is open.
Continue cycles of 30 chest compressions and 2 rescue breaths. Do not stop CPR except in one of
these situations:
▪ You find an obvious sign of life, such as breathing.
▪ An AED is ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.
If at any time you notice the child begin to breathe, stop CPR, keep the airway open
and monitor breathing and for any changes in the child’s condition until EMS personnel take over.
CPR FOR AN INFANT
If during your check you find that the infant is not breathing, begin CPR by following these steps:
▪ Find the correct location for compressions. Keep one hand on the infant’s forehead
to maintain an open airway. Use the pads of two or three fingers of your other hand
to give chest compressions on the center of the chest, just below the nipple line
(toward the infant’s feet). If you feel the notch at the end of the infant’s sternum,
move your fingers slightly toward the infant’s head.
▪ Give 30 chest compressions using the pads of these fingers to compress the chest.
Compress the chest about 1½ inches. Push hard, push fast. Your compressions
should be smooth, not jerky. Keep a steady rhythm. Do not pause between each
compression. When your fingers are coming up, release pressure on the infant’s
chest completely but do not let your fingers lose contact with the chest. Compress
at a rate of at least 100 compressions per minute.
▪ After giving 30 chest compressions, give 2 rescue breaths, covering the infant’s
mouth and nose with your mouth. Each rescue breath should last about 1 second
and make the chest clearly rise. Continue cycles of 30 chest compressions and 2
rescue breaths. Do not stop CPR except in one of these situations:
▪ You find an obvious sign of life, such as breathing.
▪ An AED is ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.
If at any time you notice the infant begin to breathe, stop CPR, keep the airway open and
monitor breathing and for any changes in the infant’s condition until EMS personnel take over.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
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IF CHEST DOES NOT RISE WITH RESCUE BREATHS

If the chest does not rise with the initial rescue breath, retilt the head before giving the
second breath. If the second breath does not make the chest rise, the person may be choking.
After each subsequent set of chest compressions and before attempting breaths, look for an
object and, if seen, remove it. Continue CPR.
Continuous Chest Compressions (Hands-Only CPR)
If you are unable or unwilling for any reason to perform full CPR (with rescue breaths), give
continuous chest compressions after checking the scene and the person and calling 9-1-1 or the
local emergency number. Continue giving chest compressions until EMS personnel take over or
you notice an obvious sign of life, such as breathing.

Skill Components Adult Child Infant

HAND POSITION Two hands in center Two hands in center Two or three fingers
of chest of chest in center of chest
(on lower half of sternum) (on lower (on lower half
half of sternum) of sternum, just
below nipple line)
CHEST At least 2 inches Until the About 2 inches Until About 1 1/2 inches Until
COMPRESSIONS chest clearly rises the chest clearly rises the chest clearly rises
RESCUE BREATHS (about 1 second per (about 1 second per (about 1 second per
breath) breath) breath)

CYCLE 30 chest compressions 30 chest compressions 30 chest compressions

and 2 rescue breaths and 2 rescue breaths and 2 rescue breaths

RATE 30 chest compressions in 30 chest compressions 30 chest compressions

about 18 seconds in about 18 seconds in about 18 seconds
(at least 100 (at least 100 (at least 100
compressions per compressions per compressions per
minute) minute) minute)

PUTTING IT ALL TOGETHER

Cardiac emergencies are life threatening. Every day someone will have a heart attack or go into
cardiac arrest. These cardiac emergencies usually happen in the home. If you know the signals of a
heart attack and cardiac arrest, you will be able to respond
immediately. Call 9-1-1 or the local emergency number and give care until help takes over. If the
person is in cardiac arrest, perform CPR. Use an AED if one is available. These steps will increase
the chances of survival for the person having a cardiac emergency.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

SKILL SHEET # 4
CPR—ADULT NO BREATHING
TIP: The person must be on a firm, flat surface.
After checking the scene and the injured or ill person:
1. GIVE 30 CHEST COMPRESSIONS
Push hard, push fast in the center of the chest at least 2
inches deep and at least 100 compressions per minute.

2. GIVE 2 RESCUE BREATHS

▪ Tilt the head back and lift the chin up.
▪ Pinch the nose shut then make a complete seal over
the person’s mouth.
▪ Blow in for about 1 second to make the chest clearly rise.
▪ Give rescue breaths, one after the other.
▪ If chest does not rise with the initial rescue breath,
retilt the head before giving the second breath.
▪ If the second breath does not make the chest rise, the
person may be choking. After each subsequent set of
chest compressions and before attempting breaths, look for
an object and, if seen, remove it.
▪ Continue CPR.

3. DO NOT STOP
Continue cycles of CPR. Do not stop except in one of these situations:
▪ You find an obvious sign of life, such as breathing.
▪ An AED is ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.
TIP: If at any time you notice an obvious sign of life, stop CPR and monitor breathing and for any
changes in condition.

4. WHAT TO DO NEXT
▪ use an AED as soon as one is available.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

SKILL SHEET # 5
CPR—CHILD NO BREATHING
TIP: The child must be on a firm, flat surface.
After checking the scene and the injured or ill child:
1. GIVE 30 CHEST COMPRESSIONS
Push hard, push fast in the center of the chest about 2 inches
deep and at least 100 compressions per minute.

2. GIVE 2 RESCUE BREATHS

▪ Tilt the head back and lift the chin up.
▪ Pinch the nose shut then make a complete seal over the child’s
mouth.
▪ Blow in for about 1 second to make the chest clearly rise.
▪ Give rescue breaths, one after the other.
▪ If chest does not rise with the initial rescue breath, retilt the
head before giving the second breath. If the second breath
does not make the chest rise, the child may be choking.
After each subsequent set of chest compressions and before
attempting breaths, look for an object and, if seen, remove it.
Continue CPR.

3. DO NOT STOP
Continue cycles of CPR. Do not stop except in one of these situations:
▪ You find an obvious sign of life, such as breathing.
▪ An AED is ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.

4. WHAT TO DO NEXT
▪ use an AED as soon as one is available.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.
 FITT 7 First Aid and Water Survival

SKILL SHEET # 6

CPR—INFANT NO BREAT HING

TIP: The infant must be on a firm, flat surface.

After checking the scene and the injured or ill infant:

1. GIVE 30 CHEST COMPRESSIONS Push hard, push fast in the
center of the chest about 1½ inches deep and at least 100
compressions per minute.

2. GIVE 2 RESCUE BREATHS

▪ Tilt the head back and lift the chin up to a neutral position.
▪ Make a complete seal over the infant’s mouth and nose.
▪ Blow in for about 1 second to make the chest clearly rise.
▪ Give rescue breaths, one after the other.
▪ If chest does not rise with the initial rescue breath, retilt the
head before giving the second breath. If the second breath
does not make the chest rise, the infant may be choking.
After each subsequent set of chest compressions and
before attempting breaths, look for an object and, if seen, remove it. Continue CPR.

3. DO NOT STOP
Continue cycles of CPR. Do not stop except in one of these situations:
▪ You find an obvious sign of life, such as breathing.
▪ An AED is ready to use.
▪ Another trained responder or EMS personnel take over.
▪ You are too exhausted to continue.
▪ The scene becomes unsafe.

4. WHAT TO DO NEXT
▪ use an AED as soon as one is available.

TIP: If at any time you notice an obvious sign of life, stop CPR and monitor breathing and for
any changes in condition.

Source: AMERICAN RED CROSS (2016). First aid, CPR and AED; participants manual,
Stay well health & Safety solution, p 29-44.