write in your CPR textbook

see also page 42

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On page 9 draw a line under the section on mouth to stoma ventilations and below it write:

Dentures: If the victim is wearing dentures, leave them in place unless they become loose and block the airway, dentures help support the mouth and cheeks, making it easier to seal the mask.

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On page 11 write: atmospheric air= 21% oxygen, rescue breathing = 16% oxygen, Bag-valve mask = 21% oxygen.

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On page 14 at the end of the page, write: "Do not offer Tylenol, Ibuprofen or coated aspirin products."

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On page 17 write: The two most common types of abnormal heart rhythm that can be corrected by defibrillation are V-fib and V-tach.

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On page 18 write: It is possible to receive a mild shock if an implantable ICD delivers a shock to the person during CPR. The risk to responders is minimal because the amount of electrical energy involved is low.

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On page 22, step 2, write: Tell the person calling to come back and tell you what 911 says.

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On page 23 after the words "If no breathing but there is a pulse, give 1 ventilation about every 5 seconds" write this: if the breaths do not make the chest fully rise, go to page 34

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This material is from the lifeguard text and better explains part of the primary assessment. Add it to page 23.

After checking for a pulse,

Give 2 ventilations if appropriate

For victims of cardiac arrest (witnessed sudden collapse), it is necessary to immediately begin CPR chest compressions. However, in certain situations, such as drowning or another respiratory event, giving ventilations before beginning CPR is important because children and infants, as well as adult victims of hypoxia, are more likely to experience respiratory emergencies.

For adults:

If you find an adult who is unconscious and not breathing as a result of drowning, hypoxia, or another respiratory problem, you should give the victim 2 ventilations before starting compressions.

However, if an adult is not breathing and does not have a pulse, you should assume that the problem is a cardiac emergency. In this case, skip the 2 ventilations, and begin CPR chest compressions.

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On page 26, to make the skill a bit more easy to do, add the words "put your elbow on the floor" in this part in section 2": "Using your hand closest to the head, cup the base of the skull in your palm, put your elbow on the floor and carefully slide your forearm under the shoulder closest to you."

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On page 27 at the top write: if no pocket mask, put your mouth on their mouth and pinch their nose shut, for an infant put your mouth over their mouth and nose.

At the bottom of page 27, after the words "If the chest does not fully rise, provide care for an unconscious choking victim" write this: see page 34

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On page 30 add: "If the conscious choking victim is much taller than you and you can't get into a proper position to give back blows and/or abdominal thrusts, you can ask them to kneel."

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(On page 31 it says "if the victim becomes unconscious: carefully lower the victim to the ground and provide care for an unconscious choking victim."

But on page 13 your text says: "Conscious Choking Victim Who Becomes Unconscious. If the victim becomes unconscious, carefully lower the victim to the ground, open the mouth and look for an object . Continue to provide care for an unconscious choking victim.")

add the words "open the mouth and look for an object" in the sentence on page 31.

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In the note on page 31, add "or in a wheelchair" after the words "or known to be pregnant."

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At the top of page 34 write: "push, peek, puff".

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On page 36 at step 1 write: 30 compressions should take about 18 seconds

On page 38 at step 2 write: 30 compressions should take about 18 seconds; 15 compressions should take about 9 seconds

On page 39 at step 4 write: 2 minutes of compression/ventilations for an adult would be five sets, for an infant it would be nine sets.

On page 40 at step 2 write: Also wipe a small child's or infant's back dry.

Write on page 41: real AED pads are stickier than the practice ones, be careful of gloves getting stuck to the AED pads.

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Copy the following and paste it on the notes page at the back of your text, (which would be page 42 if all the pages were numbered) and also write "lightning - see page 42 " next to the words Special Situations on page 19)

If someone gets hit by lightning, or even nearly hit, they may be thrown a distance, so if they need ventilations (also known as rescue breathing and/or artificial respiration) you'll need to treat them as a spinal injury and use a modified jaw thrust rather than head-tilt chin-lift. If you are out in the wilderness, away from quick EMS help, you might need to give ventilations for a whole hour or even longer. Don't give up if they still have a pulse.

Medicine for Mountaineering says:

"Clearly the emergency treatment for a lightning victim consists of immediate, and sometimes prolonged, artificial respiration. (Cardiac resuscitation should be given also, if needed, but the heart most often resumes beating on its own.) Over seventy percent of the persons struck by lightning have enough disruption of brain function to lose consciousness. Recovery of enough function to resume breathing commonly takes as long as twenty to thirty monutes, and occasionally takes hours.

If more than one person has been struck by lightning, which commonly occurs, attention should be directed first to the ones who are lying still, not breathing and appear dead. Those who are groaning or rolling around, although unconscious, are breathing and do not require immediate attention."

You can reassure anyone who might have lost vision or has some paralysis that it is common with a lightning hit, and is usually temporary. Short term memory may be lost for a few days.

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Add these notes in the NOTES section on page 42:

Hepatitis B virus can live on a surface, exposed to the air and dried, for two weeks

Kevlar gloves are puncture resistant. Nitrile gloves are resistant to most moderate chemicals. If you use latex, touch victim as little as possible until you know if they are allergic to latex.

Recommended adult vaccinations: Tdap (Tetanus, diptheria, pertussis), MMR (measles, mumps, rubella), Varicella, Zoster, Influenza, human papillomavirus, sometimes Pneumococcal, Meningococcal, Hepatitis A, Hepatitus B.

To clean a surface with potential pathogens, after the area has been cleaned up, flood the area with a freshly made disinfectant solution (one part bleach to nine parts water) and let it stand for at least ten minutes. Never pour undiluted bleach straight from the bottle onto spills of blood, urine, sputum or vomit. Dangerous levels of toxic chlorine nitrous oxide gases could result.