Breathing in .NET

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Breathing
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The use of the look, listen, and feel method is a simple way to determine the patient s breathing status Look to see if the person is struggling to breathe Is
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PART III: REVIEW FOR THE WRITTEN EXAMINATION
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the patient breathing very quickly or slowly When encountering an unconscious person, check to see if the chest of the victim is rising and falling Check the color of the skin Blue-gray color around the mouth and the end of the ngers is usually attributed to a lack of oxygen to the body and respiratory distress Listen to the victim Put your ear next to the victim s nose and mouth and listen for the sounds of breathing, if the person is unconscious If the person is conscious, is he or she able to communicate dif culty breathing Is the patient experiencing loud, labored breathing In an unconscious victim, feel for breathing by placing your hand on the chest to check for movement Place the side of your head next to the victim s mouth and feel for any air movement against your cheek A victim who is not breathing requires the administration of positive pressure ventilation (PPV) methods or rescue breathing
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First responders frequently utilize a combination xed- ow inhalator (for patients who are able to breathe with dif culty) and mouth-to-mask rescue breathing resuscitator (for patients who are not breathing) oxygen unit to provide supplemental oxygen to victims having dif culty breathing or forced ventilation to those who are not breathing Cylinders typically provide 20 to 60 minutes of oxygen to the patient depending on how the unit is being used
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MOUTH-TO-MASK VENTILATION (POCKET MASK RESCUE BREATHING)
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A common and relatively safe rescue breathing method performed today by re ghters is known as mouth-to-mask ventilation The transparent plastic pocket mask used has a one-way valve that provides a barrier that can prevent the transmission of communicable diseases between the victim and the rst responder The valve diverts the patient s exhalations It also allows the re ghter to create a tight seal around the patient s nose and mouth in order to perform effective rescue breathing The rst responder takes a position at the top of the victim s head as shown, maintains an open airway, and places the pocket mask over the victim s nose and mouth The re ghter then places his or her mouth over the mouthpiece of the pocket mask The re ghter breathes slowly into the mouthpiece, causing the victim s chest to rise visibly The re ghter then allows the victim to exhale by removing his or her mouth from the mouthpiece
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Another rescue breathing method utilizes a bag-valve-mask device The bag-valve-mask is made of soft, collapsible plastic and can be used to provide air forcibly to the victim with or without supplementary oxygen attached All these rescue breathing devices and equipment are used in conjunction with an OPA
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RESCUE BREATHING
First responders should administer two rescue breaths without checking for circulation Take a normal breath before giving mouth-to-mask ventilation
CHAP 14: EMERGENCY MEDICAL CARE
Each rescue breath should be given over one second If the rst rescue breath does not cause the victim s chest to rise, use the head tilt-chin lift before attempting the second rescue breath If unsuccessful, begin cardiopulmonary resuscitation (CPR)
Circulation
Assess the patient s circulation by checking for bleeding, pulse rate, and skin color Analyze the scene to see if the patient is bleeding heavily (hemorrhaging) Uncontrollable bleeding is potentially life threatening Is there a pool of blood on the ground Are there blood stains on the victim s body, hair, or clothing Check the back of the victim for the possibility of hidden blood The loss of large amounts of blood can also cause the victim to go into shock A shock victim may exhibit pale skin color The patient s skin color also re ects the status of the circulatory system Bluish (cyanotic) skin indicates a restriction of oxygen to the living tissues and organs of the body The pulse rate is commonly taken at one of the four arteries listed below, dependent on whether the victim is responsive or unresponsive and his or her age Determine if the pulse rate is regular or irregular, fast or slow, weak or strong A patient without a pulse requires the rst responder to start CPR
CARDIOPULMONARY RESUSCITATION (CPR)
CPR should be administered by rst responders on victims of cardiac arrest (not breathing and lacking a pulse) It is used to provide oxygen (rescue breaths) and promote blood ow (compressions) to the body s heart and brain When blood stops circulating, oxygen cannot be transported to the body s vital organs and tissues Without oxygen for four to six minutes, brain cells begin to die Ensure that the victim is on the ground or on a hard surface with his or her head up Rescuers place themselves on their knees at the side of the victim in a position to readily check for breathing and pulse as well as administer CPR
Adult CPR (One or Two Rescuers)
Adult CPR techniques are performed on victims from 15 years old and up Generally two rst responders administer CPR to an adult One rescuer checks the pulse and delivers rescue breathing while the other rescuer administers compressions Occasionally, both duties are performed by a lone rescuer The compression and rescue breathing ratio and rate are the same for either one- or two-rescuer CPR After checking and opening the victim s airway and looking, listening, and feeling for breathing; two rescue breaths are given (the standard technique for all age groups) The carotid pulse is then checked and, if there are no signs of circulation, the rescuer gives 30 chest compressions at a rate of 100 compressions per minute, followed by two breaths (at a rate of one breath per second) A pulse check should be performed frequently In two-rescuer CPR, rotate the rescuer performing compressions every two minutes
Note: Chest compressions are given with the heel of one hand positioned on the lower portion of the sternum (chest bone) between the nipples Place the heel of the other hand on top and interlace your ngers Elbows are locked as compressions are given directly over the sternum Once the chest is compressed, it should be allowed to come back up to its original position
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