other performs ventilation (fig. 4-20). The ratio
for the two person CPR is 5 compressions to 1
ventilation, at a rate of 80 compressions per
minute. One rescuer is positioned at the chest area
and the other beside the victims head. The
rescuers should be on opposite sides of the vic-
tim to ease position changes when one rescuer gets
tired. Changes should be made on cue without in-
terrupting the rhythm.
To help avoid confusion, one rescuer must be
designated the leader. The leader must make the
preliminary checks of the victims vital signs and
perform the initial 2 ventilations. The second
rescuer will get ready for compression and per-
form the compressions.
When CPR is started, give the compression
in a constant, methodical rhythm. The rescuer giv-
ing the compressions counts them out loud (one
one thousand, two one thousand, three one thou-
sand, four one thousand, five one thousand). As
the fifth compression is released, the other rescuer
ventilates the victim. Allow a short pause to ven-
tilate the victim.
CPR for Children and Infants
Closed chest cardiac massage for children is
similar to that for adults. The primary difference
is that the heel of only one hand is used to depress
the middle of the sternum from 3/4 to 1 1/2
inches. The other hand can be used to maintain
a head tilt that helps ventilation. For infants, only
two fingers are used to depress the middle of the
sternum from 1/2 to 3/4 of an inch. For both in-
fants and children, the compression rate increases
from 80 to 100 compressions per minute.
The head-tilt or jaw thrust methods of ensur-
ing an open airway will cause the upper back of
an infant or small child to arch upward. Addi-
tional support for the back is provided by a folded
towel, sheet, or blanket.
SOFT TISSUE INJURIES
The most common injuries seen by the corps-
man in a first aid setting are soft tissue injuries
with the accompanying hemorrhage, shock, and
danger of infection. Any injury that causes a
break in the skin, underlying soft tissue structures,
or body membranes is known as a WOUND. This
section will discuss the classification of wounds,
the general and specific treatment of soft tissue
injuries, the use of dressings and bandages in
treating wounds, and the special problems that
arise because of the location of wounds.
Figure 4-20.Two-rescuer CPR technique.
CLASSIFICATION OF WOUNDS
Wounds may be classified according to their
general condition, size, location, the manner in
which the skin or tissue is broken, and the agent
that caused the wound. It is usually necessary for
you to consider these factors to determine what
first aid treatment is appropriate for the wound.
General Condition of. the Wound
If the wound is fresh, first aid treatment con-
sists mainly of stopping the flow of blood, treating
for shock, and reducing the risk of infection. If
the wound is already infected, first aid consists
of keeping the victim quiet, elevating the injured
part, and applying a warm wet dressing. If the
wound contains foreign objects, first aid treat-
ment may consist of removing the objects if they
are not deeply embedded. DO NOT remove ob-
jects embedded in the eyes or the skull, and do
not remove impaled objects. Impaled objects must
be stabilized with bulky dressing before transport.