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Eric Fisher

Program Director

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 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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