CPR in the wilderness

Cardiopulmonary resuscitation (CPR) is the combination of rescue (mouth-to-mouth) breathing and chest compression in a non-breathing and pulseless victim.


CPR should be started even if the victim may be without a heartbeat or breath for a prolonged time. Actually, it is difficult to know exactly how long a person found unconscious in the wilderness has been in cardiac arrest. Moreover, it is well established that after 10-15 min of CPR, victims who do not respond never will; the only rare exceptions have been victims who were profoundly hypothermic. In general, if CPR is not successful in resuscitating the victim after 15-30 min, and the victim is not profoundly hypothermic, the effort should be discontinued.

CHEST COMPRESSION

The victim should be placed on his back on a firm surface.

1. Position the heel of one hand over the center of the victim's breastbone (about two fingers up from his xiphoid) and the heel of the second hand over the bottom hand, interlocking the fingers.
2. Your shoulder should line up directly over the victim's breastbone, with elbows straight.
3. Compress the breastbone 2.5-5 cm keeping your arms stiff and using a smooth motion, The compression phase should equal the relaxation phase (rate: 80-100 compressions per minute). Do not remove your hand from victim's breast between compressions.


During CPR, check every few minutes for the return of a pulse or spontaneous breathing. If a single person is performing the rescue, he should alternate 10 chest compressions with two mouth-to-mouth breaths. If two rescuers are working together, the first rescuer should pause after every fifth compression so the second rescuer can give the victim a mouth-to-mouth breath.

In children (older than one year), place the heal of your hand on the child's lower breastbone, with the fingers lifted off the chest. Compress the breastbone about 1/3 to 1/2 the thickness of the chest (2.5-3.5 cm). The chest should be compressed at a rate of approximately 100 per minute, stopping to give the child a breath every five compressions. Continue the compression-to-breathing ratio of 5:1, whether one or two people are doing the resuscitation. Stop to check for a pulse and spontaneous breathing after one minute, and then after every few minutes. 

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