Monday, July 26, 2010
For CPR chest compressions you will want to place the heel of one hand - either one - on the chest on the spot where an imaginary line drawn between the nipples crosses the breast bone.
The one big "no-no" during CPR chest compressions and during the Heimlich Maneuver is pressing on the xyphoid process. This is also known as "That thingy at the bottom of the breast bone". It can snap off the breastbone if you push hard on it. If that happens, every time you press the chest, that sharp object has an opportunity to lacerate something inside, resulting in an internal bleed-out and making it impossible to bring the victim back.
To avoid hitting the xyphoid process during chest compressions, find the bottom end of the sternum and make sure your hands are positioned at least an inch above it.
You can see an example of where to place your hands at www.slicc.org in the second video down from the top. It's important to keep your elbows straight and rock from the hips. If you try to press the chest by repeatedly bending and extending your arms, you won't last until help arrives.
...and what if you can't get down onto the ground to do the compressions? You can use a foot! Take your shoe off - particularly if you are wearing spiked heels - and place your foot on the sternum with the heel closer to the head, but not over the throat. You may want to use a chair to steady yourself. Remember that compressions don't have an impact to them: you are not going to be "kicking" the victim's chest, you are going to be compressing it 1.5 to 2 inches, 100 times a minute - just about the same speed as the BeeGee's 'Staying alive'. There are no style points for chest compressions. All the victim needs is 1.5 to 2.0 inches of compression - with full recoil so that the lungs can re-fill - 100 times a minute.
...and what if you can't press on the victim's chest with your hands because of bad arthritis? Place your forearm on the victim's sternum - elbow closest to the chin but not over the throat - and place the other hand or forearm on top of the first forearm, rocking at the waist to pump the chest. See http://www.slicc.org/RegularAndArthritic/RegularAndArthritic.m4v
The need to keep the blood flowing to the brain trumps everything.