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 victim’s head. The rescuers should be on opposite sides of the victim to ease position changes when one rescuer gets tired. Changes should be made on cue without interrupting the rhythm.
To help avoid confusion, one rescuer must be designated the leader. The leader must make the preliminary checks of the victim’s vital signs and perform the initial 2 ventilations. The second rescuer will get ready for compression and perform the compressions.
When CPR is started, give the compression in a constant, methodical rhythm. The rescuer giving the compressions counts them out loud (one one thousand, two one thousand, three one thousand, four one thousand, five one thousand). As the fifth compression is released, the other rescuer ventilates the victim. Allow a short pause to ventilate the victim.
Figure 4-20.—Two-rescuer CPR technique.
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 infants and children, the compression rate increases from 80 to 100 compressions per minute.
The head-tilt or jaw thrust methods of ensuring an open airway will cause the upper back of an infant or small child to arch upward. Additional support for the back is provided by a folded towel, sheet, or blanket.
SOFT TISSUE INJURIES
The most common injuries seen by the corpsman 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.
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 consists 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 treatment may consist of removing the objects if they are not deeply embedded. DO NOT remove objects embedded in the eyes or the skull, and do not remove impaled objects. Impaled objects must be stabilized with bulky dressing before transport.
