Question:
I just finished giving a BLS CPR course here at work to people on the Cyanamid ARC First Aid Squad and got a couple of questions I could not answer.
1. "Do some of the signs and symptoms of heart attack manifest themselves differently in women than men?" 2. "How come the chest compressions for obstructed airway in the infant are in the same place as compressions for cardiac arrest? You don't give compressions to anyone with a pulse."
Answer:
First, and I mean this in the most compassionate way possible, if you need the answers to these questions, you should stop instructing CPR until you have read the book and taken a refresher course. Second,, the answers are yes and yes, some of us DO compressions with a pulse....however, in the case of the infant, there is a reason you DON'T do abdominal compressions.....
This question arises from the misconception that pressure applied to the chest is the same for CPR and attempts to dislodge a foriegn object. CPR employs chest compressions; a technique that essentially is attempting to "squeeze" the heart between the sternum and spine. These compressions should be delivered smoothly and not in a jerky motion. Attempts to dislodge foriegn objects employ chest thrusts; a technique that is attempting to rapidly increase the air pressure behind the foriegn object, causing it to be expelled. Each thrust should be a separate, individual attempt to create enough force to expell the object. The thrust is delivered quickly, as slow thrusts would permit the internal organs to comply to the force and move away from it, not causing the external force to be transmitted to the lungs to create the increased internal pressure that is needed to force the object out.
As a side note, in Pediatric Advanced Life Support (P.A.L.S.), providers are taught that slow, ineffective heart rates in infants require the addition of external chest compressions in an effort to increase the perfusion, so the non-use of chest compressions on patients with pulses is not completely accurate.
