4-3

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4-3. CHANGE FROM ONE-RESCUER CARDIOPULMONARY RESUSCITATION TO TWO-RESCUER CARDIOPULMONARY RESUSCITATION

One of the first actions a lone rescuer takes is to call for help. If another person who is qualified to administer CPR comes to his aid after he has begun one-rescuer CPR, he can change from one-rescuer CPR to two-rescuer CPR. In the procedures given below, the original rescuer (the one administering one-rescuer CPR) is called the first rescuer. The new person coming to help the first rescuer is called the second rescuer.

a. Identify Self. The second rescuer informs the first rescuer that he is qualified to assist the first rescuer by saying, "I know CPR," or a similar comment.

b. Kneel. The second rescuer positions himself on the opposite side of the casualty from the first rescuer in order to give each rescuer room to perform his functions and to lessen the chance of physical contact between the rescuers. The second rescuer then kneels near the casualty's chest in position to administer chest compressions.

NOTE: The first rescuer continues to perform one-rescuer CPR while the second

rescuer identifies and positions himself.

c. Administer Chest Compressions. After the first rescuer administers two full breaths to the casualty, the second rescuer administers thirty chest compressions. The first rescuer remains at the casualty's head and checks the casualty's carotid pulse to determine the effectiveness of the chest compressions.

(1) If the second rescuer's chest compressions are actually causing the heart to pump blood, a pulse will be felt.

 

(2) If no pulse is felt within 5 seconds, the first rescuer informs the second rescuer that no pulse is being felt. The second rescuer then alters his compression technique so that a pulse is felt.

d. Continue Efforts to Aid Casualty.

(1) If the casualty has spontaneous heartbeat and respiration, one rescuer can check the casualty for additional injuries while the other rescuer continues to monitor the casualty.

 

(2) If the casualty's heart is beating on its own but the casualty is not breathing on his own, the one rescuer administers rescue breathing while the other rescuer looks for injuries.

 

(3) If no pulse is detected after checking for 5 seconds, the first rescuer opens the casualty's airway, administers two breaths, and says, "Continue CPR." The second rescuer resumes administering chest compressions. Both rescuers now administer CPR using two-rescuer CPR

cycles (thirty compressions followed by two ventilations). After five cycles, the rescuers again check for spontaneous heartbeat and respiration, and change positions.

 

(4) If the first rescuer is fatigued, the first rescuer administers two ventilations and tells the second rescuer to administer one-rescuer CPR. While the second rescuer is performing one-rescuer CPR, the first rescuer checks the effectiveness of the ventilations by observing the casualty's chest, checks the effectiveness of the compressions by feeling for a carotid pulse, and (if needed) seeks additional help. When the first rescuer has recovered sufficiently, he informs the second rescuer that he will assist in administering two-rescuer CPR, positions himself by the casualty's head, and checks for spontaneous heartbeat and spontaneous respiration (paragraph d).

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