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Emergency Cardiovascular Care Library
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Emergency Cardiovascular Care Library (American Heart Association).ISO
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Book_PBLS
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pg07_04.htx
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pg07_04
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1998-01-05
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<BODY TEXT="#bafddc" BGCOLOR="#006666" LINK="#ffcc66" ALINK="#fb1814" VLINK=
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<H1><FONT COLOR="#eca413">Performance Guidelines</FONT></H1>
<H2><FONT COLOR="#f38568">Relief of Obstructed Airway: Infant Becomes Unconscious</FONT></H2>
<P><TABLE WIDTH="800" BORDER="1" CELLSPACING="2" CELLPADDING="5">
<TR>
<TD WIDTH="25%"> </TD>
<TD WIDTH="25%"><B><FONT COLOR="#ffffff">Objectives</FONT></B></TD>
<TD WIDTH="25%"><B><FONT COLOR="#ffffff">Critical Performance</FONT></B></TD>
<TD WIDTH="25%"><B><FONT COLOR="#ffffff">Reason</FONT></B></TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"><P><IMG SRC="Book_PBLS/PBLS_source_art/inf_help.gif" WIDTH="167" HEIGHT="134" ALIGN=
"BOTTOM" NATURALSIZEFLAG="0"></P>
<A NAME="anchor1"></A>
<P><IMG SRC="Book_PBLS/PBLS_source_art/inf_tongjaw.gif" WIDTH="167" HEIGHT="158"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><P><B><FONT COLOR="#ffffff">Assessment:</FONT></B><BR>
Loss of consciousness in infant with complete airway obstruction. Shout
for help.</P>
<A NAME="anchor2"></A>
<P> </P>
<A NAME="anchor3"></A>
<P> </P>
<A NAME="anchor4"></A>
<P> </P>
<A NAME="anchor5"></A>
<P><B><FONT COLOR="#ffffff">Action:</FONT></B><BR>
Perform tongue-jaw lift. Remove obstructing object if you see it.</TD>
<TD WIDTH="25%" VALIGN="TOP"><P>Call out "Help!" If someone comes, that person should activate
the EMS system. Position infant on back.</P>
<A NAME="anchor6"></A>
<P> </P>
<A NAME="anchor7"></A>
<P>Open the mouth using tongue-jaw lift by placing your thumb in the infant's
mouth over the tongue. Lift the tongue and jaw outward. If you see a foreign
body, remove it. <B><FONT COLOR="#ffffff">Do not</FONT></B> perform a blind
finger sweep.</TD>
<TD WIDTH="25%" VALIGN="TOP"><P>This initial call will alert bystanders and may enable them to activate
the EMS system while you try to relieve the obstruction.</P>
<A NAME="anchor8"></A>
<P> </P>
<A NAME="anchor9"></A>
<P>Remove the object if you see it. Blind finger sweeps should <B><FONT
COLOR="#ffffff">not</FONT></B> be performed because they may push the obstructing
object back into or further into the <BR>
airway.</TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/inf_mouth.gif" WIDTH="163" HEIGHT="127"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><A NAME="anchor511858"></A><B><FONT COLOR="#ffffff">Action:<BR>
</FONT></B>Attempt to give 2 rescue breaths. If unsuccessful, reposition
the head and try again.</TD>
<TD WIDTH="25%" VALIGN="TOP">Open airway with head tiltchin lift and try to give breaths. If the
chest does not rise, reposition the head and try again to give rescue breaths.</TD>
<TD WIDTH="25%" VALIGN="TOP">You must ensure that the head is properly positioned before you decide that
the airway is obstructed by a foreign body.</TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/inf_blow.gif" WIDTH="173" HEIGHT="182"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><B><FONT COLOR="#ffffff">Action:<BR>
</FONT></B>Deliver up to 5 back blows.</TD>
<TD WIDTH="25%" VALIGN="TOP">Deliver back blows with infant positioned face down (as before).</TD>
<TD WIDTH="25%" VALIGN="TOP"> </TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/inf_thrust.gif" WIDTH="164" HEIGHT="156"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><B><FONT COLOR="#ffffff">Action:</FONT></B><BR>
Deliver up to 5 chest thrusts over the lower half of the sternum (avoid
the xiphoid).</TD>
<TD WIDTH="25%" VALIGN="TOP">Find finger position as for chest compressions and deliver up to 5 compressions.</TD>
<TD WIDTH="25%" VALIGN="TOP"> </TD></TR>
<TR>
<TD WIDTH="25%"> </TD>
<TD WIDTH="25%" VALIGN="TOP"><B><FONT COLOR="#ffffff">Action:<BR>
</FONT></B>Perform tongue-jaw lift. Remove object if seen.</TD>
<TD WIDTH="25%" VALIGN="TOP">If you see the object, remove it. <B><FONT COLOR="#ffffff">Do not</FONT></B>
perform blind finger sweeps.</TD>
<TD WIDTH="25%" VALIGN="TOP">Blind finger sweeps may push the object back into or further into the airway.</TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/inf_tongjaw.gif" WIDTH="163" HEIGHT="153"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><A NAME="anchor580158"></A><B><FONT COLOR="#ffffff">Action:</FONT></B><BR>
After each series of 5 back blows and 5 chest thrusts, perform tongue-jaw
lift and remove object if seen. Open the airway and try to give rescue breaths.
If unsuccessful, reposition head and reattempt breaths.</TD>
<TD WIDTH="25%" VALIGN="TOP">Repeat these steps until rescue breaths are given successfully. If you are
alone, activate the EMS system after about 1 minute of efforts to clear
the airway.</TD>
<TD WIDTH="25%" VALIGN="TOP">Some airway obstruction may be caused by incorrect head and neck position.</TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/boy_phone.gif" WIDTH="180" HEIGHT="195"
ALIGN="BOTTOM" NATURALSIZEFLAG="3"></TD>
<TD WIDTH="25%" VALIGN="TOP"><B><FONT COLOR="#ffffff">Action:</FONT></B><BR>
Activate the EMS system after approximately 1 minute.</TD>
<TD WIDTH="25%" VALIGN="TOP"> </TD>
<TD WIDTH="25%" VALIGN="TOP">Activation of the EMS system will ensure the arrival of trained personnel.</TD></TR>
<TR>
<TD WIDTH="25%" VALIGN="TOP"> <IMG SRC="Book_PBLS/PBLS_source_art/inf_pulse.gif" WIDTH="170" HEIGHT="140"
ALIGN="BOTTOM" NATURALSIZEFLAG="0"></TD>
<TD WIDTH="25%" VALIGN="TOP"><B><FONT COLOR="#ffffff">Action:</FONT></B><BR>
When obstruction is removed, check for breathing and pulse.</TD>
<TD WIDTH="25%" VALIGN="TOP"><P>Open the airway and check for breathing.</P>
<A NAME="anchor10"></A>
<UL>
<LI><FONT COLOR="#ffffff">If there is no breathing, give 2 breaths. Check
for a pulse.</FONT>
<UL>
<LI><FONT COLOR="#ffffff">If a pulse is present, provide 20 breaths per
minute and continue to monitor pulse.</FONT>
<LI><FONT COLOR="#ffffff">If there is no pulse, begin cycles of compressions
and breaths.</FONT>
</UL>
<LI><FONT COLOR="#ffffff">If breathing resumes and there is no evidence
of trauma, place the infant on one side in the recovery position and await
the arrival of emergency personnel.</FONT>
</UL>
</TD>
<TD WIDTH="25%" VALIGN="TOP"> </TD></TR>
</TABLE>
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