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August 2, 2020

BehindTheMedspeak: "What should you do if you come across an unconscious person?"


That was the question posed in a "Health Mailbox" feature in the Wall Street Journal, answered below.

Q: What should you do if you come across an unconscious person, as in the case of actor Heath Ledger?

A: Emergency physicians say the first step is to verify that the person really is unconscious. Shout, shake her, or dig your knuckles into her collarbone. That may revive her.

If it doesn't, call 911. Then check to see if the person is breathing. It may be shallow so put your ear to her face to feel for any movement of air. Also watch to see if her chest is rising. If you don't detect breathing, tilt her chin back, open her mouth, and clear out anything that may be blocking her airway. Then check again for breath. Also check for a pulse; the easiest place is under the jawline on either side of the windpipe.

If the unconscious person is breathing and has a pulse, you don't need to do anything else. Just stay by her side until assistance comes.

If there's no breath or pulse, the 911 dispatchers may ask you to perform cardiopulmonary resuscitation (CPR).

The new CPR eliminates so-called "rescue breathing" and focuses on chest compressions.

Make it hard and deep (try for 2" of up-and-down movement with each compression) and fast — 100 times a minute without interruption.

Don't worry about sharp cracking sounds — those are ribs breaking and it means you're doing it correctly.

It's completely acceptable collateral damage and happens all the time in Code Blues in hospitals.

Keep on with the chest compressions.

CPR performed properly can get very tiring even for experts: I find five minutes of chest compressions is the max I can do before I start to noticeably slack off in terms of power and frequency.

If there's someone else around, draft them to help while you rest.

More on the new CPR here.

CPR training?

You just had it.

One more thing: if there's another person in the vicinity, don't forget to have them raise the unconscious person's legs.

August 2, 2020 at 10:01 AM | Permalink


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