(3) If no pulse is detected after checking for 5 seconds, the ventilator
rescuer opens the casualty's airway, administers two breaths, and says, "No pulse."
The compressor rescuer resumes administering chest compressions and two-rescuer
CPR is continued.
h. Continue Cardiopulmonary Resuscitation Cycles and Checks. If the pulse
is absent, continue to administer two-rescuer CPR using the cycle of thirty chest
compressions followed by two breaths. After administering CPR for about two minutes,
both rescuers stop their efforts and the ventilator rescuer checks the casualty for
spontaneous pulse and breathing. If the check shows no change, two-rescuer CPR is
resumed. A check is made every five cycles (about every 2 minutes).
i. Switch When Needed. If the rescuer administering chest compressions
becomes tired, the rescuers can switch functions. (Note: The same general
procedures can be used if another qualified rescuer appears and wishes to give one of
the rescuers a rest.) It is important to change compressors about every two minutes to
ensure adequate rate and depth of compressions.
(1) The rescuer administering the chest compressions calls for the switch by
counting "CHANGE and two and three and four and five..."
(2) After the compressor rescuer gives the thirtieth chest compression, he
moves to the position for giving rescue breathing at the casualty's head without moving
to the casualty's other side.
(3) The ventilator rescuer administers two breaths after the thirtieth
compression and moves to the casualty's chest without changing sides.
(4) The rescuer at the casualty's head (formerly the compressor rescuer,
now the ventilator rescuer) checks for spontaneous heartbeat and breathing (about 5
(5) The other rescuer (formerly the ventilator rescuer, now the compressor
rescuer) locates the chest compression site and positions himself to deliver chest
(6) If the casualty still has no pulse, the new ventilator rescuer says, "No
pulse," and administers two ventilations. The new compressor then begins
administering chest compressions. Both rescuers continue to administer two-rescuer
(a) If the casualty's heart has resumed beating but the casualty is not
breathing, the new ventilator rescuer continues to administer rescue breathing while the
other rescuer looks for injuries.