(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).
CONTROL COMPLICATIONS WHILE PERFORMING CARDIOPULMONARY
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.