3 Slide your fingers alongside the larynx in the groves formed by
the muscles at the side of the neck.
4 Palpate the pulse. Avoid pressing too hard and compressing
the artery. You will block out a weak pulse if you do this.
(b) Cardiopulmonary resuscitation (CPR). If there is no carotid pulse,
begin artificial circulation (CPR) using external chest compression. Follow these steps:
1 Place the casualty on his back on a hard surface.
2 Position yourself at the left side of the casualty's chest.
3 Locate the lower half of the casualty's sternum. Avoid putting
pressure on the tip of the sternum (xiphoid process).
4 Place the heel of your hand over the lower half of his sternum,
keeping your fingers off the chest wall.
5 Put the heel of your second hand on top of the first, and move
so that your shoulders are lengthwise over the casualty's sternum. Keep your arms
straight and your elbows locked.
6 Exert a firm, heavy force downward on the chest. For adults, 80
to 120 pounds of pressure are required to depress the sternum 1 1/2 to 2 inches. By
using your entire weight, you should be able to compress the casualty's chest. This
compresses the heart and forces blood into the arteries.
7 Release the pressure, but do not remove your hands. Develop
a rhythm by rolling your body forward to press and then back to release.
8 Continue compressions at the rate of 80 per minute. Continue
until the casualty revives or until you are relieved. If another rescuer relieves you,
change places with that person without interrupting the rhythm of chest compressions.
Be sure to give two lung inflations after each 15 compressions.
9 For further information, refer to Subcourse MD0571, Cardiac
Impairment, and look at Lesson 3 (Basic Cardiac Life Support).
b. Make a Rapid Physical Assessment. If organs are exposed, DO NOT
PUSH THEM BACK IN. Cover exposed organs with sterile dressings. Pick
organs which may be on the ground. Do this with a clean, dry dressing or with the
cleanest available material. Put the organs on top of the casualty's stomach.