4-4

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4-4. CONTROL COMPLICATIONS WHILE PERFORMING CARDIOPULMONARY RESUSCITATION

a. Gastric Distention. During rescue breathing or CPR, air may enter the casualty's esophagus (the tube leading from the throat to the stomach) and cause the stomach to inflate. This condition is called gastric distention. Gastric distention can be caused by the rescuer delivering the ventilations with too much force, by improperly positioning the casualty's head (airway not open), or by an obstruction in the casualty's airway preventing his lungs from filling quickly. Gastric distention can cause vomiting and may decrease the lung volume by pushing up on the diaphragm.

(1) If the stomach becomes distended, reposition the casualty's airway. Watch for the rise and fall of the casualty's chest, and breathe only hard enough to cause the chest to fully rise. Continue administering rescue breathing or CPR. Do not push on the casualty's abdomen in an attempt to reduce the distention since the pressure could cause the casualty to vomit.

 

(2) Gastric distention can be corrected by adjusting the airway and adjusting the force of the ventilations. More advanced procedures may be appropriate, such as the use of a nasogastric tube to decompress the abdomen. If this is not available, then proper ventilation and opening of the airway are the primary methods to reduce further distention.

b. Vomiting (Regurgitation). If the casualty vomits, roll the casualty onto his side so that his front is toward you and administer a finger sweep to wipe out his mouth. Then return him to the supine (flat on his back) position. If possible, suction the patient to clear the airway. Then continue administering CPR or rescue breathing.

c. Dentures. Dentures support the rescuer's lips and make sealing the casualty's mouth easier. Do not remove dentures from the casualty's mouth unless they are loose or broken. If it is necessary to remove dentures, put them in the casualty's pocket so that they will accompany the casualty when he is evacuated. If dentures are blocking the casualty's airway, perform a finger sweep to remove them (paragraph 5-6c).

d. Fractures. Fractures of the ribs or sternum may occur even if CPR is performed properly. Care should be taken to ensure proper hand placement and technique in order to reduce the danger of fractures. Fractures of

the ribs or sternum (including the xiphoid process) can puncture or lacerate a lung, liver, aorta, stomach, or heart. Cardiac tamponade (blood in the pericardial sac) is caused by a lacerated pericardium. If injuries occur, continue performing CPR.

e. Biological Death. Cardiopulmonary resuscitation is not always successful. Success or failure may be influenced by the time that elapsed before CPR was started, injuries, drugs, poisons, and/or preexisting conditions such as heart disease, kidney failure, and stroke. You should not blame yourself or others for failure to save the casualty if a sincere effort was made to revive the casualty.

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