Special
considerations
The following conditions may or
may not require changes in standard CPR procedures. However,
each condition requires some special consideration.
Condition Changes or Special Considerations
Pregnancy
Assess scene/victim: (no change).
A=Airway (no change)
B=Breathing (no change).
C=Compressions (change)
Chest compressions may not be effective when a woman who is
6 months pregnant or more is lying flat on her back. This
is because the baby puts pressure on a major vein that returns
blood to the heart. If possible, prop up the woman slightly
on her left side using a rolled blanket (or similar) when
performing chest compressions. This will reduce the pressure
and provides the most blood flow to mother and baby. Perform
chest compressions higher on the breastbone, slightly above
the center.
D=Defibrillation (no change)
Hypothermia
Assess scene/victim: (change).
Get inside or out of the wind. Prevent additional heat loss
by removing wet clothes and insulating the victim from further
exposure. If the body is frozen solid, nose and mouth are
blocked with ice and chest compression is impossible, do not
start CPR.
A=Airway (no change)
B=Breathing (no change).
C=Compressions (no change)
D=Defibrillation (change).
If the victim does not respond to one shock, focus on continuing
CPR and re-warming victim to a range of 30 degrees C. to 32
degrees C. (86-89.6F) before repeating defibrillation attempt.
Submersion/Near
Drowning
Assess Scene/victim: (change)
CAUTION! The scene may be
unsafe (waves, currents, cold water, bad weather). Proper
training and use of personal lifesaving equipment, such as
torpedo buoys and personal flotation devices, is critical
for a safe rescue. If available, get the victim into a boat
or other vessel. If no boat is available, get the victim to
shore. Start BLS/CPR when indicated, as soon as it is safe
to do so.
A=Airway (no change)
B=Breathing (change)
Expect vomiting. When it occurs, turn the victim’s mouth
to the side and remove the vomit with a gloved finger sweep
or cloth. If a head, neck or back injury is suspected, use
the HAINES method or roll the victim like a log. Minimize
movement. Avoid twisting the head, neck or back. Do not attempt
to drain water from the lungs using abdominal thrusts or the
Heimlich maneuver. It is unnecessary and potentially dangerous
C=Compressions (no change)
D=Defibrillation (change)
Move victim out of freestanding water and dry chest before
attaching AED.
Electric Shock
Assess scene/victim
(change).
Consider any fallen or broken wire extremely dangerous. Do
not touch (or allow your clothing to touch) a wire, victim
or vehicle that is possibly energized. Do not approach within
eight feet of it. Notify the local utility and have trained
personnel sent to the scene. Metal or cable guard-rails, steel
wire fences and telephone lines may be energized by a fallen
wire and may carry the current a mile or more from the point
of contact. NEVER attempt to handle wires yourself unless
you are properly trained and equipped. Start BLS/CPR if indicated,
as soon as it is safe to do so.
A=Airway (no change)
B=Breathing (no change)
C=Compressions (no change)
D=Defibrillation (no change)
Lightning
Strike
Assess Scene/victim: (change)
When multiple victims are struck by lightning at the same
time, give the highest priority to those without signs of
life. Start BLS/CPR if indicated, as soon as it is safe to
do so. Because many victims are young, they have a good chance
of survival if immediate CPR is given.
Remove smoldering clothing, shoes and belt to prevent burns.
A=Airway (no change)
B=Breathing (no change)
C=Compressions (no change)
D=Defibrillation (no change)
Cardiac
arrest and Injury
Assess scene/victim: (no change)
A=Airway (change)
Clear mouth of blood, vomit and other secretions.
B=Breathing (no change)
C=Compressions (no change)
D=Defibrillation (no change)
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