Unconsciousness

See if there is any breathing. If not, start artificial respiration as described in arrested breathing and also check for a pulse. Here’s how to do it:

Place your fingers in the hollow between the windpipe and the large neck muscles. Press backwards here and check for a pulse for up to ten seconds.

If there is no pulse, follow this procedure:

• Kneel beside the subject.
• Look at the subject's chest and locate one of his lowermost ribs with the index and middle fingers of your lower hand. Slide these fingers along this rib to the point where the lowermost ribs meet the breastbone. Place your middle finger at this point and your index finger above it on the lower breastbone itself.
• Place the heel of your other hand on the breastbone, and slide it down until it reaches your index finger. This is the point at which you are going to apply pressure.
• Place the heel of your first hand on top of the other hand, and interlock your fingers.
• Leaning well over the subject, with your arms straight, press down vertically, depressing the breastbone approximately 4-5 cm (1½ - 2 in). Release the pressure without removing your hands. Remember that pressure should be applied through the heels of the hands only.
• Compress the chest 15 times, aiming for a rate of about 100 compressions per minute – this will be helped by saying out loud: 'one and two and three and four…' etc.
• Then give two breaths of artificial ventilation, as described in artificial respiration .
• Continue the cycle of alternating 15 chest compressions with two breaths of artificial ventilation until help arrives.

• Put the baby on its back on a flat surface and remove any obvious obstruction from the mouth.
• Feel for the baby's pulse at the inner surface of the upper arm, or over the upper part of the chest to the left of the midline (over the heart). Don't forget to check for up to ten seconds. For an older child you can check the carotid pulse (neck/windpipe) as for an adult.
• While you are doing this, look for other signs of recovery, such as a return of colour to the skin, and any signs of movement – like breathing, swallowing or coughing.
• If there is no pulse, find the place between the nipples where the ribs meet on the lower part of the breastbone.
• Place two fingers at this place and press down sharply to a third of the depth of the chest.
• Do this five times at a rate of 100 per minute.
• If there is no breathing, seal your lips tightly around the mouth and nose for a baby or just the mouth for a child.
• Breath into the lungs until the chest rises.
• Give five breaths.
• Then alternate five chest compressions with one breath of mouth-to-mouth ventilation.
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