American Red Cross certified corpsman, nurse,
One Rescuer Technique
The rescuer must not assume that an arrest
has occurred solely because the victim is lying
on the floor and appears to be unconscious. First,
try to arouse the victim by gently shaking the
shoulders and trying to obtain a response; (loudly
ask: Are you O.K.?). If there is no response,
place the victim supine on a firm surface. Kneel
at a right angle to the victim, and open the
airway using the head tilt or jaw thrust methods
described previously. Attempt to ventilate. If
unsuccessful, reposition the head and again
attempt to ventilate. If still unsuccessful, deliver
four abdominal or chest thrusts to open the
airway. Repeat the thrust sequence until the
obstruction is removed.
Once the airway has been opened, check for
the carotid pulse. The carotid artery is most
easily found by locating the larynx at the front
of the neck and then sliding two fingers down
the side of the neck toward you. The carotid
pulse is felt in the groove between the larynx
and the sternocleidomastoid muscle. If the
pulse is present, ventilate as necessary. If the
pulse is absent, locate the sternum and begin
closed cardiac massage.
To locate the sternum, use the middle and
index fingers of your lower hand to locate
the lower margin of the victims rib cage
on the side closest to you (fig. 4-18A). The
fingers are then moved up along the edge
of the rib cage to the notch where the ribs
meet the sternum in the center of the lower
chest (fig. 4-18B). The middle finger is placed
on the notch and the index finger is placed
next to it. The heel of the other hand is
placed along the midline of the sternum next
to the index finger (fig. 4-18C). Remember to keep
the heel of your hand off the xiphoid tip of the
sternum. A fracture in this area can damage the
liver, causing hemorrhage and death.
Place the heel of one hand directly on the ster-
num and the heel of the other on top of the first
(fig. 4-18D). Interlock your fingers or extend them
straight out and KEEP THEM OFF THE VIC-
Lean or rock forward with the elbows locked
and apply vertical pressure to depress the sternum
(adult) 1 1/2 to 2 inches. Then release the
pressure, keeping the hands in place on the chest.
You will feel less fatigue if you use the proper
technique and a more effective compression will
result. Ineffective compression occurs when the
elbows are not locked, the rescuer is not directly
over the sternum, or the hands are improperly
placed on the sternum.
When one rescuer performs CPR, as shown
in figure 4-19, the ratio of compressions to ven-
tilation is 15 to 2, and it is performed at a rate
of 80 compressions per minute to maintain 60 full
compression each minute. Vocalize: one and,
two and, three and, . . . until you reach 15.
After 15 compressions, you must give the victim
2 ventilation. Continue for four full cycles.
Quickly check for the carotid pulse and spon-
taneous breathing. If there are still no signs of
recovery, continue CPR. If a periodic check
reveals a return of pulse and respiration, discon-
tinue CPR, but closely monitor the victim and be
prepared to start CPR again if required.
Before learning the next technique, review the
steps to take for a cardiac arrest involving one
Determine whether the victim is conscious.
Check vital signs.
Ventilate two times (it may be neces-
sary to remove an airway obstruction at
Again check vital signs; if there are none,
begin the compression-ventilation rate of
15 to 2 for four complete cycles.
Check pulse, breathing, and pupils; if there
is no change, continue the compression-
ventilation rate of 15 to 2 until the victim
is responsive, you are properly relieved, or
you can no longer continue.
If there are two people trained in CPR on the
scene, one must perform compression while the