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Chapter 42 — 4
If the rescuer has the equipment and skills, help secure the airway using an airway device (eg guedel
airway), and ventilate using mouth to mask, a self inflating bag (eg Ambubag) with or without
oxygen, or an oxygen inflating device ( eg Oxyviva).
Give two full inflations of one second each then:
Check the circulation
C — CIRCULATION
If the victim is unconscious, unresponsive and not breathing it can be assumed that there is no
circulation and external cardiac compression (ECC) should be started (Australian Resuscitation
Council recommendation).
Note: Previous protocols recommended feeling for a pulse at this stage. This has now been omitted
as it is often difficult to feel a pulse in these circumstances, even by medical personnel, and feeling
for a pulse and then deciding there is none delays the start of life saving ECC.
Advanced resuscitators such as doctors or paramedics may check for circulation by feeling for a
carotid pulse before commencing ECC. But this may be unreliable even in experienced hands and no
more than 10 seconds should be used checking for a pulse. If there is no pulse, or any doubt,
commence ECC.
When there is no circulation, the sooner ECC is commenced, the better the outcome.
Commence external cardiac compression (ECC) and Cardiopulmonary
Resuscitation (CPR)
External cardiac compression.
Circulation sufficient to keep the victim alive can be restored
with this technique. The chest is compressed by pressure on the sternum, forcing blood into the
major arteries and producing some circulation to the vital organs. It takes numerous compressions to
establish a blood pressure adequate to provide circulation. If compressions are stopped, the blood
pressure immediately falls and the process has to be restarted. Thus the number of times
compressions are stopped should be minimized.
The combination of artificial respiration and external cardiac compression is called CPR. This is
performed as follows.