muscle. If the pulse is present, ventilate as necessary.
If the pulse is absent, locate the sternum and begin
PROPER POSITIONING OF HANDS ON
STERNUM.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. 4-14). Then move your fingers up along the
edge of the rib cage to the notch where the ribs meet the
sternum in the center of the lower chest. Place your
middle finger on the notch and your index finger next
to it. Place the heel of your other hand along the
midline of the sternum next to your index finger.
Remember to keep the heel of your hand off the
xiphoid (tip of the sternum). A fracture in this area may
damage the liver, causing hemorrhage and death.
CHEST COMPRESSIONS.Place the heel of
one hand directly on the sternum and the heel of the
other on top of the first. Interlock your fingers or
extend them straight out and KEEP THEM OFF THE
Effective compression is
accomplished by locking your elbows into position,
straightening your arms, and positioning your
shoulders directly over hands so that the thrust for each
chest compression is straight down on the sternum.
See figure 4-15. The sternum should be depressed
approximately 1 ½ to 2 inches (for adults). Release
c h e s t c o m p r e s s i o n p r e s s u r e b e t w e e n e a c h
compression to allow blood to flow into the chest and
heart. When releasing chest compression pressure,
remember to keep your hands in place on the chest.
Not only will you feel less fatigue if you use the
proper technique, but a more effective compression
Figure 4-13.Locating the carotid pulse.
Figure 4-14.Proper position of hands on the sternum for
Figure 4-15.Proper position of the rescuer.