student nurse question!

Nurses General Nursing

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Hey everyone:

I am new to this forum, so I hope I am posting this question in the right place.

I'm just starting to take actual nursing classes this spring, and I'm a little unsure of the basics of some things. I'd like to get it cleared up now so I don't feel like I'm asking dumb questions later.

Alright, here it goes. I know about the ABS'c of CPR, but I'm confused on how you know to progress to the next step. I know I'll have to take a CPR class anyway, and I have a few summers ago, but Ifelt like they just pushed everyone through and didn't explain it too well. I know that when you find an unresponsive victim, you need to open their airway by tilting their head back and then you need to then assess their breathing. Then breathing is absent, you breathe into their mouth two times.

My question is, if you find someone unconscious BUT they are breathing, (after activiating the EMS), do you just put them into the recovery position? Do you not need to check for circulation (carotid pulse)as long as they are breathing? In other words, do you only check for the pulse/signs of circulation if they are NOT breathing (to see if you have to initiate chest compressions if the pulse is absent)? Since I thibk breathing is one sign of circulation, I am guessing that as long as they are breeathing on their own, their heart is pumping?

I know this might seem like an obvious answer to most of you, but I just really want to make sure I understand it. Thanks so much for any help!

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Specializes in Critical Care/ICU.
I'd like to get it cleared up now so I don't feel like I'm asking dumb questions later.
There are no "dumb" questions, ever (either now or later).

I know that when you find an unresponsive victim, you need to open their airway by tilting their head back and then you need to then assess their breathing.
Actually in basic CPR, if you're by yourself, you've established unresponsivemness, and it's an adult (or >8 yrs old), you run to call 911 FIRST. If someone is with you, you send them to call 911 and then proceed with positioning the airway and rescue breaths. If it's a child or infant and you're alone, you proceed with CPR for one minute and then call for help.

Then breathing is absent, you breathe into their mouth two times.
Yes, making sure you get chest rise. And then you check circulation (carotid pulse, brachial on an infant).

My question is, if you find someone unconscious BUT they are breathing, (after activiating the EMS), do you just put them into the recovery position?
Yes, as long as you're sure that they don't have a neck injury.

Since I thibk breathing is one sign of circulation, I am guessing that as long as they are breeathing on their own, their heart is pumping?
Breathing is a sign of circulation. You are absolutely right.

You should visit www.americanheart.org

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I understand much better now! Have a great day :)

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Actually in basic CPR, if you're by yourself, you've established unresponsivemness, and it's an adult (or >8 yrs old), you run to call 911 FIRST.

I don't want to step on anyone's toes. But when I took the healthcare provider cpr/first aid given by the LVN school and red cross I was attending about a year ago, I was taught that if I was alone with the person that needed cpr, for me to perform cpr for 1 minute before attempting to call 911. My husband took the same class and says it is 2 minutes before calling 911.

Just my 2 cents.

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Specializes in Critical Care/ICU.

adults: http://depts.washington.edu/learncpr/quickcpr.html

children 1-8 http://depts.washington.edu/learncpr/childrencpr.html

infants http://depts.washington.edu/learncpr/infantcpr.html (doesn't say do CPR for one minute before calling for help, but that's what you do)

I would post the American Heart Associations links, but I've been trying to access the AHA website all day without success. It must be down, but it will tell you the same thing.

I don't want to seem to be a stickler on the way to do it (an attempt at CPR is better than no CPR at all), but if one is being tested on CPR, the correct answers are important.

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Specializes in NICU.

In all of the AHA Healthcare Provider CPR classes that I have taken, it's always been taught to do CPR for about 1 minute (for children

The Red Cross certification might be different, I don't know. I have only been certified through AHA.

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Specializes in Education, Acute, Med/Surg, Tele, etc.
In all of the AHA Healthcare Provider CPR classes that I have taken, it's always been taught to do CPR for about 1 minute (for children

The Red Cross certification might be different, I don't know. I have only been certified through AHA.

My hubby and I taught it that way, and you are right. Activate 9-11 after a min of breathing for children under 8, because think about it...smaller/younger body can't handle hypoxia as well as an adult! And remember...for infants or very small children..puff not BLOW...when you panic you tend to go fast and hard...be aware of this (it isn't easy really..trust me...adreniline is hard to overcome sometimes!). Get 9-11 though after a min...they have the equipment needed for anything beyond CPR...keep on with the CPR till paramedics arrive if needed.

With adults..the reason for immediate 9-11 is they are more likely to need a defib or invasive procedures to save their lives. Immediate 9-11 call, and get to work ASAP.

The thing that people tend to forget is simplicity...ABC! Airway, Breathing, Circulation! That order! If airway is okay, breathing is okay..check circulation...never hit the old circulation first..you just wasted breathing time taking a pulse! It will take a time or two to get it down, if you are so fortunate/unfortunate to gain the experience you will know what to do almost automatically or with less stress than your first or second time! Yep, it is one of those learn as you do deals, no real way around it!

Also...something that is always forgotten in the old classes:

1. Adults...the popping of ribs is normal and do NOT let it stop you from doing compressions. We can fix ribs, only if they are alive though! You will never forget that feeling of a rib pop, but once you have had it happen, I say you are initiated...LOL! I knew it was coming and I still was "oh lordie!". Old folks are almost a guarentee for rib fx or pop...don't let it scare you, it is a part of life and can't be changed!

2. CPR=poop/pee and vomit! Just know that...another part of life! But a nice thing to know when you are bagging someone and all the sudden...oops glad I wasn't doing mouth to mouth!

3. Don't freak out about the counts as much as making each compression or breath matter. If they don't have a pulse/breathing they are dead, so you can't really do much more damage in trying to get them back...try not to stress over it, especially if you find yourself stopping to count or get your counting back! If I screw up on a count, I go for a rescue breath and start compressions again...like hitting a reset button!

4. Do not worry about patient comfort at this time! I have seen more pillows under heads hindering airways, or big blankets getting in my way. Comfort is nice, but for the living! Get those blankets out of there, get that pillow out of there...get them on the floor or a cpr board under them and get moving!

5. If possible get that shirt OFF, bra OFF...no time for patient modesty! But focus on CPR first...the paramedics have shears for this purpose...so if you can get those off (say someone is having still breathing and you think they are going to crash...go for it...but if they are pulseless/apnec don't bother..get to 9-11 call and CPR).

6. It is actually more common for heart attacks to occur during rest periods or night/morn than when folks are exercising! People tend to forget this...and denial is very high "well they were just sleeping...heart attacks happen when you are active"..NOPE! Actually when you are active, your heart is usually quite functional in doing its job, it is after when you are resting...when much of your arterial constriction occurs, occludes areas, and MI ensues! Just a little reminder there :). Pain on exertion is normally more muscle related and the bodies way of telling you "hey this is too much and hurts"...it is resting after that that will get it going (IE the reason for nitro for angina..get those arteries open because those muscles need that O2, they have been overworked!).

I know that is a lot of info...but from someone that does tons of CPR, I like to get in a few tricks of the trade for newbies or reminders for other professionals. Feel free to ask me any other questions..I am a bit rusty on ACLS (I don't use that much, and about to take my class again..I get rusty just about the time I need to renew), but BLS..go for it!!!!! I may go back to teaching this really soon...I loved teaching this stuff!!!!!

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Specializes in Critical Care/ICU.

Soon2BNurse

I talked with my daughter about this thread tonite. She's an American Red Cross CPR instructor. A couple of years ago the ARC changed the way they instruct CPR to standardize it with the AHA.

It used to be--work on the pt for a minute, then call, no matter their age.

The ARC doesn't teach work first then call anymore. It's universal no matter who teaches it now and the way that the OP, others in this thread and I have described it.

To add to TriageRN_34's excellent post, another reason why you do ABC's on an infant or small child for one minute before calling for help is because most times it's a respiratory issue with this population, specifically an obstructed airway that a defibrillator cannot help but a person trained in obstructed airway, whether it's a medic or a layperson, can.

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