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Cardiopulmonary Resuscitation When you perform cardiopulmonary resuscitation (CPR), you are using mouth-to-mouth resuscitation to help the person breaths and chest compressions to help the person's heart pump blood. The brief review of CPR on the following pages can help you in an emergency; however, this information should not take the place of a certified course in ;-PR. Immediate care Assess the situation. Call out for someone to get help, or call 911 yourself if the person does not seem to need immediate assistance. You can determine this by gently shaking the person and asking in a loud voice "Are you OK?" If there is no response, begin CPR and continue until help arrives.

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CPR on an Infant Basic CPR on an infant is five chest compressions and one breath.

1 To find a pulse, locate the brachial artery in the upper arm. It is located on the underside of the arm between muscle and bone. Use two fingers to feel for the pulse

2 If the baby is not breathing, tilt the head back slightly to open the airway. Put a washcloth or thin pad of clothing under the baby's shoulders. This keeps the head from assuming its naturally forward position. Form a seal with your mouth over the baby's mouth and nose. Blow one breath (a smaller breath than you would give to an adult), so that the baby's chest rises.

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3 If the baby has no pulse, use two fingers to perform chest compressions. Place your fingers one finger width below an imaginary line connecting the infant's nipples. Push down 1 inch with each compression. Count out loud: " 1 and 2 and 3 and 4 and 5. " You may have to repeat the five compressions and one breath multiple times. You will push adult down on the chest 120 times per minute. Continue, alternating five compressions and one breath, until help arrives.

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CPR on a Child Age 8 or Older or on an Adult 1 Lay the person on a hard, flat surface. Look into the mouth and throat to ensure that the airway is clear. If an

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object is present, try to sweep it out with your fingers. Use disposable surgical gloves if they are available. If vomiting occurs, turn the person on his or her side and sweep out the mouth with two fingers. Do not place fingers in the mouth if there is rigidity or if the person is having a seizure.

2 Tilt the head back slightly to open the airway. Put upward pressure on the jaw to pull it forward.

3 Look for the person's chest to rise and fall. Listen for the sounds of breathing. Feel for the

person's breath on your cheek.

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4 If the person is at all responsive (if he or she is moaning, breathing blinking, or moving any part of the body), his or her heart is beating; do not perform steps 6 or 7. If the person is not breathing, perform mouth-to-mouth resuscitation, even if the heart is beating. If the person is breathing, cover with a blanket or clothing as for shock. If the person is not responsive, feel for a pulse on the carotid artery. The artery is in the groove of the neck off to the side of the Adam's apple. If you do not feel a pulse, go to step 5 immediately.

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5 If the person is not breathing, pinch the nostrils closed with your thumb and index finger. Place your mouth tightly over the person's mouth (use a mouthpiece if one is available). Blow two quick breaths and watch for the person's chest to rise. Release the nostrils.

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6 If the heart is not beating, kneel at the person's right side. With the fingers of your right hand, find the bottom of the breastbone (in the center where the ribs meet). Place your index and middle fingers side by side, just above the bottom of the breastbone. Place the heel of your left hand just above your fingers, on the breastbone. Move your right hand and place it on top of the left, and interlock the fingers of the two hands

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7 With your elbows straight, push down briskly (about 2 inches) with the heel of your hand 1 5 times over about 1 0 seconds. Let the chest rise after each compression. CPR for an adult includes 15 chest compressions and two breaths. You may have to repeat the 15 chest compressions and two breaths multiple times. Push down on the chest 80 to 1 00 times per minute. Continue until breathing begins or help arrives. Count out loud: 1 and 2 and 3 and 4 and 5," until you reach 15. Release your hands. Repeat step 5 and watch for the person's chest to fall. Feel for air being exhaled. Repeat, starting

at step 5.

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Choking A person who is choking will instinctively grab at the throat. The person also may panic, gasp for the breath, turn blue, or be unconscious. If the person can cough he or she is getting air. Nothing should be done.

Immediate care If the person cannot cough or speak, begin the Heimlich maneuver immediately to dislodge the object blocking the windpipe. The Heimlich maneuver creates an artificial cough by forcing the diaphragm up toward the lungs.

If you are choking and alone You can perform the Heimlich maneuver on yourself by giving yourself abdominal thrusts. Or position yourself over the back of a chair or against a railing or counter and press forcefully enough into it so that the thrust dislodges the object.

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Heimlich Maneuver on an adult If the person is sitting or standing, stand behind him or her. Form a fist with one hand and place your fist, thumb side in, just below the person's rib cage in the front. Grab your fist with your other hand.

Keeping your arms off the person's rib cage, give four quick inward and upward thrusts. You may have to repeat this several times until the obstructing object is coughed out.

If the person is lying down or unconscious, straddle him or her and place the heel of your hand just above the waistline. Place your other hand on top of this hand. Keeping your elbows straight, give four quick upward thrusts. You may have to repeat this procedure several

times until the obstructing object is coughed out.

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Helmlich Maneuver on a Child

Stand behind the child. With your arms around his or her waist, form a fist with one hand and place it, thumb side in, between the ribs and waistline. Grab your fist with your other hand. Keeping your arms off the child's rib cage, give four quick inward and upward thrusts. You may have to repeat this several times until the obstructing object is coughed out.

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Heimlich Maneuver on an Infant 1 Place the infant facedown across your forearm (resting your forearm one on your leg) and support the infant's y head with your hand. Give four forceful blows

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to the back with the heel of your hand. You may have to repeat this several times until the obstructing object is coughed out.

2 If this does not work, turn the baby over. With two fingers one finger width below an imaginary line connecting the nipples, give forceful thrusts to the

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chest to a depth of 1 inch. You may have to repeat this several times until the obstructing object is coughed out.