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- Check for response
- If no response i.e. unresponsive and lack of normal breathing i.e. no breathing or gasping
- Activate EMS (Emergency Medical Services or Emergency Response Team) and get or call for an AED (automated external defibrillator)
- Check for the carotid pulse (continue to check pulse every two minutes). Check the pulse for MAXIMUM of 10 seconds.
- If no pulse then start chest compressions
- The rescuer should place the heel of one hand on the center (middle) of the victim's chest (which is the lower half of the sternum) and the heel of the other hand on top of the first so that the hands are overlapped, and the arms are locked at the elbow and at 90 degrees to the victim's chest
- Start compressions ( at least 2 inches in depth) at the rate of at least 100 per minute
- After 30 compressions, open the airway and give breath head tilt-chin lift (push the forehead back with one hand and lift the chin to move the jaw forward with the other hand)
- Give 2 breaths, each for 1-second duration, and look for chest rise. If the first breath doesn't make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re administer the breaths. Give one breath, every 5-6 second intervals (10-12 breaths per minute).
- Continue 30 compressions followed by 2 ventilations i.e. ratio of 30:2, until an advanced airway (i.e., endotracheal tube, Combitube, or laryngeal mask airway-LMA) is placed; then start continuous chest compressions with ventilations at a rate of 1 breath every 6 to 8 seconds (8 to 10 ventilations per minute).
- AED should be used as soon as it is available, resume chest compressions immediately after the shock is given.
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