Community CPR Tutorial 2006
Complete the FREE online tutorial, print out the "Certificate of Completion" (this is not your CPR certification card), then attend a Know CPR class within two weeks of completing the FREE online course.

Bring the certificate to a Know CPR class where you will receive hands-on training, and a two-year nationally-recognized CPR certificate from the American Safety and Health Institute upon passing a standard multiple-choice test.

Contact Know CPR at 703-528-7045 or Info@KnowCPR.com

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Introduction
This Know CPR Online Tutorial is for the sole purpose of assisting individuals in their preparation for a Know CPR First Aid or CPR training course.





The information contained in this online tutorial is based on generally available information, updated June 2006, and should not be considered as a substitute, in any part, for hands-on training by a certified instructor.
INSTRUCTIONS
You must successfully complete the quiz at the end of the tutorial plus the "Attestation" to earn your certificate of completion for the tutorial.

To navigate though the course, click on the arrow buttons on the bottom right corner of each page.

To see the entire course outline or skip through the course, click the "Site Map" button at the top of each the page. To return to the course, click the "back" button.

You may take this tutorial as often as you like for FREE.

        CHAIN OF SURVIVAL
        Place a short summary of this chapter's topics here.
        Chain of Survival
        This tutorial focuses on the "Chain of Survival" (the essential steps rescuers should take) for victims of all ages:

        As a rough guideline:

        -Adult CPR is performed on those who have reached puberty and older

        -Child CPR is performed on children who have not yet reached puberty

        -Infant CPR is performed on ages under one year of age

        Heart Attack
        A common sudden illness experienced by adults is a Heart Attack.

        Heart Attack: A blockage that prevents the flow of oxygenated blood to the heart.

        Symptoms: Chest pain, tightness in the chest, radiating pain up the jaw or down the left arm, dizziness, ill feeling.

        Symptoms can vary, and can be severe or mild.

        If not treated immediately, a Heart Attack can result in a victim not breathing and not having circulation.

        Recognize these early symptoms and activate EMS by calling 911 immediately. Time is of the essence.

        Stroke

        Another common sudden illness experienced by adults is a stroke.

        Stroke: A blockage preventing the flow of oxygenated blood to the brain:

        Symptoms: headache, blurred vision, confusion, loss of strength on one side (in the arm or leg), facial droop, slurred speech, dizziness.

        Symptoms can vary, and can be severe or mild.
        If not treated immediately, a stroke can result in a victim not breathing and not having circulation.

        Recognize these early symptoms and activate EMS by calling 911 immediately. Time is of the essence.
        Risk Factors:
        You should know that the following factors increase the risk of experiencing a heart attack and/or stroke:

        -Family history

        -Age

        -Smoking cigarettes

        -High blood pressure

        -High blood cholesterol

        -Race

        -Gender
          Recovery Position:
          As a rule, never move an injured victim. However, if the victim becomes weak and dizzy the rescuer should lay the victim on their side before leaving to call 911. This sideways position, known as the recovery position, reduces the chance of choking if the victim passes out and vomits while alone.

          Use the HAINES Position for injured victims. "HAINES" stands for "High Arm In Endangered Spine" and is a modified recovery position.

          Roll victim to side so that the victim's head rests on extended arm. Bend both legs at knees to stabilize victim

          When using the HAINES position there is less neck movement and less risk of spinal cord damage.
              ADULT CPR




              Do you know what to do in the event of an emergency?
              ADULT CPR

              Do you know what to do in the event of an emergency?

                    1. Check for Responsiveness
                    You walk into a room and find grandpa on the sofa. Should you call 911 right away?

                    Of course not. Grandpa could be sleeping!

                    How can you tell if grandpa is OK or needs help?
                    Check for responsiveness.

                    After making sure that the scene is safe, tap him gently on the shoulders and yell out his name. If grandpa does not respond, he needs help fast.
                      2. Activate EMS (CALL 911)
                      If grandpa needs help, you should immediately tell someone to call 911 so that you can stay and help.

                      If you are alone, get up and call 911 immediately, then come back.

                      The help you give "buys time" until advanced medical care arrives.

                      Any delay in calling 911 can significantly reduce grandpa's chance of a full recovery.
                            3. Start ABCs

                            After you call 911 or activate your local EMS (Emergency Medical System), perform the
                            A-B-Cs:
                                Airway
                                1. After activating the local EMS, you need to open the AIRWAY of the unresponsive victim.

                                  Since grandpa is unconscious his tongue is probably resting against the back of his throat so no oxygen can enter his body.

                                  Sometimes opening the airway will allow the victim to start breathing.



                                1. Use the Head-Tilt Chin-Lift method to open the airway.

                                  Place one hand on the victim's forehead and the other on the chin - then lift the chin upward.

                                  This will tilt the head back and pull the tongue away from the back of the throat, opening the airway.



                                    Breathing:
                                    Is Grandpa breathing?

                                    After you open the airway, you can determine if grandpa is breathing by placing your face closely over his face and looking toward his chest. Then:

                                    -Look for the chest to rise

                                    -Listen for breathing

                                    -Feel for breath against your face.

                                    After you open the airway, if grandpa is breathing, keep the airway open and wait for help.

                                    If you open the airway and determine he is not breathing, then grandpa is not receiving the oxygen that he needs -- you must blow oxygen into his mouth (in essence, breathing for him).
                                            Breath for Grandpa?
                                            If grandpa is not breathing, keep the airway open, then pinch his nose and provide two (2) slow steady breathes into his mouth - each lasting about 2 seconds.

                                            Pinching the nose prevents the air from escaping.

                                            You will know if your breath is effective (goes in) because you will see grandpa's chest rise.

                                            If the chest does not rise from the first breath, then you should reposition grandpa's head, then try again. You may have inadvertently closed the airway by dropping the chin. Repositioning the head will ensure the airway is open.

                                                  How Hard should you blow?
                                                  For each breath, you should blow just hard enough to make the chest rise.

                                                  If you blow too hard the air will enter the stomach, causing gassiness and possibly causing grandpa to vomit (and where's your mouth? Yuck!). The vomit could also lead to further complications such as blockage.

                                                  You will know if you blow too hard because the stomach will extend.
                                                      Why did Rescue Breathes Help Grandpa?
                                                      The benefit of providing rescue breaths to grandpa is that you are providing the oxygen that he (his cells) needs.

                                                      If grandpa can't breath on his own, you are in essence breathing for him by blowing oxygen into his mouth or nose.

                                                      Blowing into the victim's mouth helps because the breath that you exhale contains more oxygen than the victim needs.

                                                      Did you know that when you exhale, not only are you exhaling CO2, but also oxygen!
                                                        Circulation
                                                        The heart pumps the oxygenated blood throughout the body delivering oxygen to cells, tissues and organs.

                                                        The heart is located in the center of the chest, under the lower part of the breast bone or sternum.

                                                        Every time the heart beats, the heart pumps the oxygenated blood throughout the body.

                                                        The movement of oxygenated blood throughout the body is called "circulation."

                                                        If the heart is not working, or not working effectively, there will not be circulation - - the cells, tissues and organs will not receive the oxygen and will soon malfunction and die.
                                                            How can you tell if there is circulation?
                                                            If the person is not breathing, then there is a strong possibility there is no circulation, which means the oxygenated blood is not moving throughout the body.

                                                            If the victim is not breathing you should assume there is no circulation.

                                                            After providing 2 breaths, immediately begin compressions.

                                                            If you perform chest compressions when you did not need to, you will NOT stop the heart. However, if you do not perform compressions when you should have, the victim can die.

                                                            How do you Locate the compression site?
                                                            By providing chest compressions directly over the heart (over the lower part of the breast bone or sternum) you will be moving the blood throughout the body by squeezing the heart.

                                                            To locate the place where you should press on the chest (the "compression site"),

                                                            Draw an imaginary line between the victim's nipples, then place the heal of your hand over the middle of the victim's chest (over the sternum or breast bone) .

                                                            Or, trace up the victim's rib cage to the little notch below the sternum or breast bone (this is called your xiphoid process). Place the heal of your hand two finger widths above the notch. Be careful not to press directly on the victim's xiphoid process as this can cause further harm to the victim.

                                                            Performing Chest Compressions
                                                            CPR is best performed when the victim is lying on their back on a hard flat surface

                                                            On an adult with no breathing:

                                                            Kneel on the side of the victim;

                                                            Place one hand on top of the other over the victim's chest. Your arms should be straight and your shoulders should be directly over your hands.

                                                            Press down 1 - 2 inches. Press down and return all the way up. Do not bounce or rock.

                                                            Provide 30 chest compressions counting as follows "1, and 2, and 3, and 4, and 5 . . . and 25, 26, 27, 28, 29, 30."

                                                            After 30 compressions, provide 2 rescue breaths.

                                                            Repeat the sequence of 30 compressions and 2 rescue breathes 5 times, or for about 2 minutes.

                                                            Reassess - checking for breathing.

                                                            If there still is no breathing continue to provide chest compressions and rescue breathes, reassessing the victim every couple of minutes (as their condition could change).



                                                            Continue to provide CPR until either help arrives, the victim recovers, or you physically can't help any more.

                                                            Conscious Choking
                                                            Foreign Body Airway Obstruction -- also known as choking -- is responsible for over 3,000 deaths a year. While this is less than many other sudden illnesses, recognizing the early signs and taking the necessary steps can increase the chance of a full recovery.

                                                            If you see someone clutching their throat with both hands, you should first ask if the person can speak or cough. If so, do not touch them. Encourage them to cough to dislodge the item from their throat on their own. If they cannot, call 911.

                                                            If they cannot speak or cough, have someone call 911. If the victim wants your assistance, then wrap your arms around their waist from behind, with your hands in a fist just above their naval.

                                                            With both hands pull in and up. This will force air up the airway, forcing the object up and out.

                                                            Repeat the upward thrusts until the object is dislodged or the victim becomes unconscious.
                                                              Unconscious Choking
                                                              If the choking victim becomes unconscious, lay the person on their back.

                                                              Call 911 if 911 has not yet been called.

                                                              Open their mouth and see if the object has become dislodged. If you can see the object, with a hooked (bent) finger, try and sweep the object out. If successful, begin the ABCs of CPR if necessary.

                                                              If after looking in the mouth you do not see the object, open the airway and check to see if the victim is breathing (the object may have been dislodged and swallowed).

                                                              If no breathing, apply one rescue breath. If the breath does not make the chest rise, reposition the head (to open the airway), and try again.

                                                              If the breath still does not enter the chest, provide 30 chest compressions. Each compression should force the object out.

                                                              After 30 compressions, open the mouth and check for the dislodged object. If you see the object, sweep it out with your finger. If not, continue the sequence of 2 rescue breaths and 30 compressions until help arrives or the object is dislodged.

                                                              Remember to check to see if the object is dislodged after the compressions, before attempting additional rescue breaths.
                                                                  Great Job!

                                                                  Now let's go over what to do for children.

                                                                        CHILD CPR
                                                                        Child CPR is performed on ages 1 to 8 years old when a victim is unconscious and cannot breath or has no circulation.

                                                                        The most common cause of death for children is injuries.

                                                                        Most accident are preventable. Prevention is the key to safety when dealing with children.
                                                                        CHILD CPR
                                                                        Child CPR is performed on a victim who has not yet reached puberty who is unconscious and cannot breath or has no circulation.

                                                                        The most common cause of death for children is injuries.

                                                                        Most accident are preventable. Prevention is the key to safety when dealing with children.

                                                                              Are You OK?
                                                                              If you enter a room and find a child laying on the floor, after making sure the scene is safe, check for responsiveness by tapping the child gently on the shoulders and yelling their name.

                                                                              If there is no response and you are with someone, one of you should call 911, and the other begin the ABCs.

                                                                              If you are alone, provide CPR for about 2 minutes, then call 911.
                                                                                  Airway: Head-tilt Chin lift
                                                                                  The preferred method for opening the airway is the Head-tilt Chin-lift
                                                                                      Child Breathing
                                                                                      Is the child breathing?

                                                                                      After you open the airway, you can determine if the child is breathing by placing your face closely over his face and looking toward his chest. Then:

                                                                                      -Look for the chest to rise

                                                                                      -Listen for breathing

                                                                                      -Feel for breath against your face.

                                                                                      After you open the airway, if the child is breathing, keep the airway open and wait for help.

                                                                                      If you open the airway and determine he is not breathing, then the child is not receiving the oxygen that he needs -- you must blow oxygen into his mouth (in essence, breathing for him).
                                                                                              Compressions
                                                                                              If at any point you determine that there is no breathing, after providing 2 breathes, begin compressions.

                                                                                              The compression site is the same as on an adult.

                                                                                              To locate the compression site on a child, kneel on the side of the victim, then trace up the rib cage to the xiphoid process (where the ribs meet below the sternum). Then place one hand 2 finger widths above the xipohoid process.

                                                                                              Or, draw an imaginary line between the child's nipples, and place the heal of one hand over the middle of the child's chest (over the sternum). Then begin compressions.
                                                                                                  30 to 2 Compressions
                                                                                                  Provide 30 compressions, followed by 2 breath, 5 times, or for about 2 minutes.

                                                                                                  After 2 minutes, call 911 or reassess if 911 has already been called.

                                                                                                  The depth of each compression should be 1 to 1 1/2 inches.

                                                                                                  The rescuer should use only one hand to perform compressions. The other hand should be placed on the child's head for stability.

                                                                                                  The rate of compressions for a child is 100 per minute. The rescuer should count:"1 and 2 and 3 and 4 and 5.....25, 26, 27, 28, 29, 30." Then provide 2 breaths.

                                                                                                  Repeat until help comes, the person recovers, or you physically cannot help anymore.
                                                                                                      Conscious Choking
                                                                                                      It is very common for a child to put something in their mouth. This increases the risk of choking.

                                                                                                      If you see a child clutching their throat with both hands, you should first ask if the child can speak or cough. If so, do not touch them. Encourage them to cough to dislodge the item from their throat on their own. If they cannot, call 911.

                                                                                                      If they cannot speak or cough, have someone call 911. If the victim wants your assistance, then wrap your arms around their waist from behind, with your hands in a fist just above their naval. You probably will need to lower your body to their level, kneeling on one leg.

                                                                                                      With both hands pull in and up. This will force air up the airway, forcing the object up and out.

                                                                                                      Repeat the upward thrusts until the object is dislodged or the victim becomes unconscious.
                                                                                                          Unconscious Choking
                                                                                                          If the choking child becomes unconscious, lay the child on their back.

                                                                                                          Open their mouth and see if the object has become dislodged. If you can see the object, with a hooked (bent) finger, try and sweep the object out. If successful, begin the ABCs of CPR if necessary.

                                                                                                          If after looking in the mouth you do not see the object, open the airway and check to see if the victim is breathing (the object may have been dislodged and swallowed).

                                                                                                          If no breathing, apply two rescue breaths. If the breath does not make the chest rise, reposition the head (to open the airway), and try again.

                                                                                                          If the breath still does not enter the chest, provide 30 chest compressions. Each compression should force the object out.

                                                                                                          After 30 compressions, open the mouth and check for the dislodged object. If you see the object, sweep it out with your finger. If not, continue the sequence of 2 rescue breaths and 30 compressions until help arrives or the object is dislodged.

                                                                                                          Remember to check to see if the object is dislodged after the compressions, before attempting additional rescue breaths.

                                                                                                          After 5 sets of 2 breaths followed by 30 compressions, call 911 if it has not yet been called
                                                                                                              INFANT CPR
                                                                                                              Infant CPR is performed on victims under the age of 1 who are unconscious, cannot breathe, and do not have circulation.

                                                                                                              SIDS, injury, and choking are common causes for death in infants. Prevention is the best way to ensure the safety of your baby.

                                                                                                              INFANT CPR
                                                                                                              Infant CPR is performed on victims under the age of 1 who are unconscious, cannot breathe, and do not have circulation.

                                                                                                              SIDS, injury, and choking are common causes for death in infants. Prevention is the best way to ensure the safety of your baby.

                                                                                                                  Are You OK?
                                                                                                                  If you enter a room and find an infant laying on the floor or who does not appear to be okay, make sure the scene is safe and then check for responsiveness.

                                                                                                                  To check for responsiveness with a baby, tap the baby's feet and shout 'Baby, babyare you okay?"

                                                                                                                  We do not want to tap the shoulders of a baby since the baby's head and neck muscles are not fully developed. If there is no response and you are with someone, one of you should call 911, and the other should begin the ABC's.

                                                                                                                  If you are alone, provide CPR for about 2 minutes, then call 911

                                                                                                                  Remember: Babies are portable. Unless you suspect a head or neck injury, bring the baby with you when you call 911.
                                                                                                                      Airway
                                                                                                                      The preferred method for opening the airway is the Head-tilt Chin-lift. With a baby, we always need to be careful in the head and neck area. The baby's head and neck muscles are not fully developed. So, with a baby we use a half-tilt when using the Head-tilt Chin-lift method

                                                                                                                        Infant Breathing
                                                                                                                        Is the infant breathing?

                                                                                                                        After you open the airway, you can determine if the infant is breathing by placing your face closely over his face and looking toward his chest. Then:

                                                                                                                        -Look for the chest to rise

                                                                                                                        -Listen for breathing

                                                                                                                        -Feel for breath against your face.

                                                                                                                        After you open the airway, if the infant is breathing, keep the airway open and wait for help.

                                                                                                                        If you open the airway and determine he is not breathing, then the infant is not receiving the oxygen that he needs -- you must blow oxygen into his mouth (in essence, breathing for him).
                                                                                                                                Infant Breathing
                                                                                                                                After opening the airway, assess for breathing by looking, listening and feeling for breath.



                                                                                                                                If the infant is not breathing, place your mouth over the baby's mouth and nose (it is not really practical to pinch the nose). Blow just enough to make the chest rise.



                                                                                                                                If the first breath does not make the chest rise, reposition the head and try again.



                                                                                                                                  Compression Site
                                                                                                                                  If at any point, you determine that there is no breathing, provide 2 breathes followed immediately by compressions over the sternum. Compressions circulate the oxygenated blood throughout the baby's body.

                                                                                                                                  To locate the compression site on an infant, kneel on the side of the victim, draw an imaginary line between the nipples. Place two fingers one finger width below the nipple line and begin compressions
                                                                                                                                      30 to 2 Compressions
                                                                                                                                      Provide 30 compressions, followed by 2 breaths, 5 times, or for about two minutes. The rescuer should then either call 911 or do their first reassessment.

                                                                                                                                      The depth of each compression should be 1/2 to 1 inch.

                                                                                                                                      The rescuer should use only two fingers to perform compressions. The other hand should be placed on the child's head for stability.

                                                                                                                                      The rate of compressions for a infant is at least 100 per minute. The rescuer should count:"1 and 2 and 3 and 4 and 5...25, 26, 27, 28, 29, 30." Then provide 2 breaths.

                                                                                                                                      Repeat until help comes, the person recovers, or you physically cannot help anymore. Reassess every few minutes.
                                                                                                                                          Conscious Choking - Part 1
                                                                                                                                          It is very common for an infant to put something in their mouth. This increases the risk of choking.

                                                                                                                                          If you see a baby clutching their throat with both hands or if the baby looks like it has stopped breathing (but is still conscious), you should encourage them to cough. This could dislodge the item from their throat. It may be difficult to get the baby to cough or they may be unable to cough. In this case, we need t help.

                                                                                                                                          If they cannot speak or cough, have someone call 911. Choking for infants is handled differently that choking for adults or children. We do not administer the abdominal thrusts, instead we use a series of back blows and chest thrust.

                                                                                                                                              Conscious Choking - Part 2
                                                                                                                                              1. Line the baby up along your arm, making sure to support the head and neck.

                                                                                                                                                Place a 'V' over the baby's face, making sure not to block the baby's mouth. Flip the baby over, making sure to maintain the 'V' - this ensures head and neck support.

                                                                                                                                                Thrust forward 5 times between the baby's shoulder blades, flip the baby, provide 5 chest thrusts one finger width below the nipple line (using 2 fingers).

                                                                                                                                                Continue for a minute, or until the object is dislodged. After a minute, call 9-1-1. Continue with the cycle of back blows and chest thrusts until the object comes out or the baby loses consciousness.
                                                                                                                                                  Unconscious Choking
                                                                                                                                                  If the choking infant becomes unconscious, lay the infant on their back on a hard flat surface.

                                                                                                                                                  Open their mouth and see if the object has become dislodged. If you can see the object, with a hooked (bent) finger, try and sweep the object out. For the baby's little mouth, use your little finger. If successful, begin the ABC's of CPR if necessary.

                                                                                                                                                  If after looking in the mouth you do not see the object, open the airway and check to see if the victim is breathing (the object may have been dislodged and swallowed).

                                                                                                                                                  If no breathing, apply one rescue breath. If the breath does not make the chest rise, reposition the head (to open the airway), and try again.

                                                                                                                                                  If the breath still does not enter the chest, provide 30 chest compressions. Each compression should force the object out.

                                                                                                                                                  After 30 compressions, open the mouth and check for the dislodged object. If you see the object, sweep it out with your finger. If not, continue the sequence of 2 rescue breathes and 30 compressions until help arrives or the object is dislodged.

                                                                                                                                                  If the object is dislodged, check breathing and circulation. You may need to do rescue breathing or CPR.

                                                                                                                                                  After 5 sets of 30 compressions followed by 2 breathes call 911 if 911 has not yet been called
                                                                                                                                                      S.I.D.S.
                                                                                                                                                      SIDS (Sudden Infant Death Syndrome)

                                                                                                                                                      The most common cause of death for infants from 1 month to 1 year. We do not know exactly what causes SIDS. However, there are some things that we can do to reduce the risks of SIDS.

                                                                                                                                                      The most important thing is to place the baby on its back when it goes to sleep. Put the baby "Back to Sleep".

                                                                                                                                                      Also, keep unnecessary items out of the baby's sleeping area: no pillows, toys, comforters, etc. If the baby needs a blanket: the baby should placed with feet at the foot of the bed, the blanket should be tightly tucked, and it should only go up to the midline. All of these steps can help reduce the risk of SIDS
                                                                                                                                                          QUIZ
                                                                                                                                                          Great Job!

                                                                                                                                                          You are now ready to demonstrate what you've learned!

                                                                                                                                                          You can take this quiz and review this tutorial as often as you like for free.

                                                                                                                                                                Select the appropriate answer for each question or enter the answer in the blank provided. When you are done, click the button to submit your answers and find out your score.

                                                                                                                                                                You must answer all questions correctly to continue
                                                                                                                                                                1. Always assess the scene to make sure it is safe before you help
                                                                                                                                                                True False
                                                                                                                                                                2. How do you determine responsiveness on an Adult or Child?
                                                                                                                                                                1. A. Shake the victim vigorously 2. B. Gently tap the victim's shoulders and ask "Are you OK?" 3. C. Blow forcefully into the victim's mouth
                                                                                                                                                                3. If the adult victim is not responsive and you are alone, you should immediately
                                                                                                                                                                1. A. Start chest compressions 2. B. Yell for help 3. C. Activate the local emergency response system (call 911) then return to provide help
                                                                                                                                                                4. ABCs stand for:
                                                                                                                                                                1. A. Airway, Breathing, Circulation 2. B. Answer Before Calling 3. C.