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BODY SYSTEMS
The Circulatory System
It delivers oxygen and nutrients to the body’s tissues and removes waste products. It
consists of the heart, blood vessels, and blood.
The Respiratory System
It delivers oxygen to the body, as well as removes carbon dioxide from the body. The
passage of air into and out of the lungs is called Inhalation. Breathing in or inhalation
is called Inspiration. Breathing out or exhalation is called Expiration. The actual
exchange of oxygen and carbon dioxide in the alveoli as well as the tissues of the
body is called Respiration.
Breathing and Circulation
1. Air that enters the lungs contains about 21% oxygen and only a trace of carbon
dioxide. Air that is exhaled from the lungs contains about 16% oxygen
and 4% carbon dioxide.
2. The right side of the heart pumps blood to the lungs, where blood picks up
oxygen and releases carbon dioxide.
3. The oxygenated blood then returns to the left side of the heart, where it is
pumped to the tissues of the body.
4. In the body’s tissues, blood releases oxygen and takes up carbon dioxide after
which it flows back to the right side of the heart.
5. All body tissues require oxygen, the brain requires more than any other tissue.

The Nervous System

It is composed of the brain, spinal cord, and nerves. It has two major functions –
communication and control. It lets a person be aware of and react to the environment.
It coordinates the body’s responses to stimuli and keeps body systems working
together.
Clinical death
 Within 1 min. - cardiac irritability
 1 - 4 min. - brain damage not likely
 4 - 6 min. - brain damage possible
Biological death
 6 - 10 min. - brain damaged very likely
 More than 10 min. - irreversible brain damage
TIME IS CRITICAL!
 Within 1 minute: cardiac irritability
 1 to 4 minutes: brain damage not likely
 4 to 6 minutes: brain damage possible
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 6 to 10 minutes: brain damage very likely

 More than 10 minutes: irreversible brain damage
UNIT OF COMPETENCY II (Part A)
CARDIOPULMONARY RESUSCITATION (CPR)
CPR is a series of assessments and interventions using techniques and maneuvers
made to bring victims of cardiac and respiratory arrest back to life.
__________ is the condition in which circulation ceases and vital organs are deprived of
oxygen.
THREE CONDITIONS OF CARDIAC ARREST
1. Cardio Vascular Collapse. The heart is still beating but its action is so weak
that blood is not being circulated through the vascular system to the brain and
body tissues.
2. Ventricular Fibrillation. Occurs when the individual fascicles of the heart beat
independently rather than in coordinated, synchronized manner that produces
rhythmic heart beat.
3. Cardiac Standstill. It means that the heart has stopped beating.
WHEN TO START CPR
If you see a victim who is:
1. Unconscious/Unresponsive
2. Not breathing or has no normal breathing (only gasping)
3. No definite pulse
Note: Responders need to generally assume that all victims have infectious diseases
so that safety protocols must be completely observed at all times.
WHEN NOT TO START CPR
All victims of cardiac arrest should receive CPR unless:
1. Patient has a valid DNR (Do Not Attempt Resuscitation) order.
2. Patients of irreversible death (Rigor Mortis, Decapitation, Dependent Lividity).

 Rigor Mortis: The postmortem stiffening of muscles due to chemical

changes in the body after death, usually beginning a few hours after death
and lasting for up to 48 hours.
 Decapitation: The complete removal of the head from the body, typically
resulting in immediate death due to severe trauma.
 Dependent Lividity (or Livor Mortis): The pooling of blood in the lowest
parts of the body after death, causing a purplish discoloration of the skin.
This typically occurs within 30 minutes to a few hours post-mortem and helps
to indicate the position of the body after death.
3. No chance of significant benefit can be expected because the vital functions
have determined.
4. Cardiac arrest of < 23 weeks of gestation or weight < 400 grams, are generally
not resuscitated.
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5. Age over 37 weeks, 2700-4000 grams.

WHEN TO STOP CPR

 S – SPONTANEOUS signs of circulation are restored
 T – TURNED over to medical services or properly trained and authorized
personnel
 O – OPERATOR is already exhausted and cannot continue CPR
 P – PHYSICIAN assumes responsibility (declares death, takes over, etc.)
 S – SCENE becomes unsafe (such as traffic, impending or ongoing violence—gun
fires, etc.)
 S – SIGNED waiver to stop CPR
COMPRESSION ONLY-CPR
If a person cannot perform mouth-to-mouth ventilation for an adult victim, chest
compression only - CPR should be provided rather than not attempting CPR. Chest
compression only - CPR is recommended only in the following circumstances:
1. When a rescuer is unwilling or unable to perform mouth-to-mouth rescue
breathing.
2. For use in dispatcher-assisted CPR instructions where the simplicity of this
modified technique allow untrained bystanders to rapidly intervene.
The Compression-Airway-Breathing (C-A-B)
 Early CPR improves the likelihood of survival.
 Chest compressions are the foundations of CPR.
 Compressions create blood flow by increasing intra-thoracic pressure and
directly compress the heart; generate blood flow and oxygen delivery to the
myocardium and brain.
CAB: COMPRESSION
CIRCULATION represents a heart that is actively pumping blood, most often
recognized by the presence of a pulse in the neck
ADULTS & ADOLESCENTS
COMPRESSION RATE: 100-120 per minute
COMPRESSION DEPTH: At least 2 inches (5 cm) but should not exceed 2.4 inches (6
cm)
CHILDREN
(age 1 year to puberty)
COMPRESSION DEPTH: At least 1/3 Antero-Posterior (AP) diameter of the chest
INFANTS
(age less than 1 year, excluding newborns)
COMPRESSION DEPTH: About 1.5 inches (4 cm)
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ADULT CPR
 Kneel facing the victim’s chest
 Place the heel of one hand on the center of the chest
 Place the heel of the second hand on top of the first so that the hands are
overlapped and parallel
CHILD CPR
 Lower half of the sternum, between the nipples
 One hand only (two hands for big children)
 30:2 for single rescuer, 15:2 for 2-man rescuer (optional for HCP)
INFANT CPR
 Just below the nipple line, lower half of sternum
 Two fingers, flexing at the wrist (one rescuer)
 2 thumb-encircling hands technique (two rescuers)
CAB: Open AIRWAY
This is done to ensure an open passage for spontaneous breathing OR mouth to
mouth during CPR.
Head-Tilt/Chin-Lift Maneuver
 Place one hand on the head and lift up the chin while tilting back.
Jaw-Thrust Maneuver
A technique that can be done by at least two highly trained BLS providers (if
suspected with cervical trauma).
REMEMBER!
 In COVID-19 Pandemic, opening the victim’s mouth without protection for the
responder is not advisable (Maintaining open airway is still a MUST during CAB).
 Cover the victim’s mouth and nose with cloth or mask before performing chest
compression.
CAB: BREATHING
 Maintain open airway
 Pinch nose shut (if mouth to mouth RB is preferred)
 Open your mouth wide, take a normal breath, and make a tight seal around
outside of the victim’s mouth
 Give 2 full breaths (1 sec each breath)
 Observe chest rise
 30:2 (Compression to Ventilation ratio)
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 5 cycles or 2 minutes
In Pandemic (Single Rescuer)
 Avoid direct mouth to mouth ventilation. Use a pocket mask if there is a need for
rescue breathing, especially for a child/infant with an arrest most likely
respiratory in nature. If unwilling and unable, Hands-only CPR is a MUST.
 Perform Hands-Only CPR until Advanced Medical Help arrives while assessing
the victim every 2 minutes’ continuous, reasonable care.
In Pandemic (Two rescuers)
 Perform chest compressions with ventilations via BVM with a ratio of 30:2 for 5
cycles or 2 minutes (30 chest compressions delivered within 15-18 seconds).
 Give 2 ventilations via a tightly sealed Bag-Valve-Mask (BVM) with a High-
Efficiency Particulate Air (HEPA) filter with 1 second each ventilation.

BASIC LIFE SUPPORT SEQUENCE

1. Verify Scene Safety
o Ensure for scene safety first.
o Survey the environment for safety and risk.
o Ensure you have standard precautions (wear personal protective
equipment [PPE]).
2. Introduce Yourself
o Introduce yourself to the victim before engaging with the victim.
o Mention your role: BLS/CPR, can help.
3. Check for Responsiveness
o Check for responsiveness by tapping the victim and asking loudly, "Are
you OK?"
o ADULT, ADOLESCENTS & CHILD BLS
o INFANT: Tap the sole of the feet.
4. Activate Emergency Response System (EMS)
o Send someone to call 911 or phone path (if available).
o If alone, use your mobile phone, have to continue with the EMS, and get
the AED if readily available before beginning CPR.
5. Recognition of Cardiac Arrest
 Unresponsive.
 No breathing or only gasping.
 No pulse.
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 Check for breathing and pulse simultaneously for no more than 10

seconds.
 CHECK FOR BREATHING
o Not normal breathing (no normal breathing).
o If not breathing, perform normal breathing for only 10 seconds.
o WHERE TO CHECK FOR PULSE
 Adult & Adolescents: Check for Carotid Pulse
 Child: Check for Carotid pulse
 Infant: Check for Brachial or Femoral Pulse
6. Perform High-Quality CPR
HIGH-QUALITY CPR
1. Correct Compression Depth.
2. Adequate Compression Rate (100-120/min).
3. Adequate Compression Depth.
o ADULT: at least 2 inches (5 cm) but should not exceed 2.4
inches (6 cm).
o CHILDREN: about 2 inches (5 cm).
o INFANTS: about 1.5 inches (4 cm).
4. Chest recoil complete with each compression.
5. Minimize interruptions to less than 10 seconds in between chest
compressions.
6. Avoidance of Excessive Ventilation.
Pediatric Cardiac Arrest Algorithm (OHCA) for Health Care Provider
1. Check Scene Safety
o Area is safe?
o Possible COVID-19 case?
o PPEs on?
2. Introduce Yourself
3. Check the victim if
o Responsive?
o Moving?
o Breathing?
o Signs of Return of Spontaneous Circulation (ROSC)?
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YES
o Monitor and observe or contact the Barnaghy Health Emergency Response
Team (BHERT)
NO
o Call for help:
 Instruct someone to call for help
 Use a phone with a hands-free option
 Get an AED defibrillator (if applicable)
 Go to AED Algorithm
4. Simultaneously check the following if:
o Breathing?
o With Pulse?
o (Shall be done within 10 seconds)
5. If no definite pulse and no breathing or no normal breathing, e.g.,
gasping:
o Cover the victim’s mouth and nose with surgical mask cloth.
6. Compress:
o Rescuer: Hands-only CPR (continuous compressions of 100-120 per
minute)
o Rescuer (15:2): Compressions to ventilation ratio if a BVM is available.
7. Re-assess after 2 minutes (refer to 5):
o If with signs of ROSC, go to 9.
o If no signs of ROSC, go to 7 or consider opportunities of continued
resuscitation.

Pediatric Cardiac Arrest Algorithm for Lay Rescuer

1. Check Scene Safety
o Area is safe?
o Possible COVID-19 case?
o PPEs on?
2. Introduce Yourself
3. Check the victim if
o Responsive?
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o Moving?
o Breathing?
o Signs of Return of Spontaneous Circulation (ROSC)?
YES
o Monitor and observe or contact the Barnaghy Health Emergency Response
Team (BHERT)
NO
o Call for help:
 Instruct someone to call for help
 Use a phone with a hands-free option
 Get an AED defibrillator
 Go to AED Algorithm


4. Cover the victim’s mouth and nose with surgical cloth.

5. Compress:
o Hands-only CPR (100-120 compressions per minute) for 2 minutes.
6. Re-assess after 7 minutes (refer to 3):
o If with signs of ROSC, go to 9.
o If no signs of ROSC, go to 6 or consider opportunities of continued
resuscitation
ADULT CARDIAC ARREST ALGORITHM (OHCA) FOR HEALTH CARE PROVIDER
1. Check Scene Safety
o Area is safe?
o Possible COVID-19 case?
o PPEs on?
2. Introduce Yourself
3. Call for help
o Instruct someone to call for help.
o Use a phone with hands-free option.
o Get an AED defibrillator.
o Go to AED Algorithm.
4. Simultaneously check the following:
o Breathing?
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o With Pulse?
5. If no definite pulse and no breathing or no normal breathing, e.g.,
gasping:
o Cover the victim’s mouth and nose with surgical mask cloth.
6. Compress:
o Rescuer: Hands-only CPR (continuous compressions of 100-120 per
minute).
o Rescuer (15:2): Compressions to ventilation ratio if a BVM is available.
7. Re-assess after 2 minutes (refer to 5):
o If with signs of ROSC, go to 9.
o If no signs of ROSC, go to 7 or consider opportunities for
continued resuscitation.
ADULT CARDIAC ARREST ALGORITHM FOR LAY RESCUER
1. Check Scene Safety
o Area is safe?
o Possible COVID-19 case?
o PPEs on?
2. Introduce Yourself
3. Call for help
o Instruct someone to call for help.
o Use a phone with hands-free option.
o Get an AED defibrillator.
o Go to AED Algorithm.
4. Cover the victim’s mouth and nose with surgical mask cloth.
5. Compress:
o Hands-only CPR (100-120 compressions per minute) for 2 minutes.
6. Re-assess after 7 minutes (refer to 3):
o If with signs of ROSC, go to 9.
o If no signs of ROSC, go to 6 or consider opportunities for
continued resuscitation.
Table
COMPONENT ADULTS & ADOLESCENTS CHILDREN INFANT

Scene safety Make sure the environment Make sure the Make sure the
is safe for rescues and environment is safe for environment is
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victim rescues and victim safe for rescues

and victim

Recognition (Breathing and pulse) No breathing or signs of No breathing or

of cardiac normal breathing signs of normal
arrest breathing

Activation of If you are alone with the Witnessed collapse — Unresponsive

emergency mobile phone, leave the Follow steps for adults (call for help
response victim at the phone, have and adolescents on the after 10
system the victim call the left: Unwitnessed seconds)
emergency response collapse — Continue for
system and return to the 5 cycles (2 minutes) of
AED before beginning CPR CPR

Compression- 30:2 30:2 for single rescuer 15:2 for 2

Ventilation (15:2 for 2 rescuer) rescuers (30
ratio compressions
with 2 breaths)

Compression At least 2 inches (5 cm) At least 1/3 of the AP At least 1/3 of

Depth diameter of the chest the AP diameter
(about 2 inches [5 cm]) of the chest
(about 1.5
inches [4 cm])

Hand Hands on the lower half of 2 hands on the lower 2 hands or 1

placement the breastbone (sternum) half of the breastbone hand on the
(sternum) chest, just below
the nipple line

Chest recoil Allow the recoil of chest Allow the recoil of chest Allow the recoil
after each compression after each compression of chest after
each
compression

Minimizing Allow for minimal Allow for minimal Allow for

interruptions interruptions interruptions minimal
interruptions

Location for Carotid Pulse Carotid Pulse Brachial Pulse or

Pulse Check Femoral Pulse
(HCP only)

Counting for 30 compressions (with 2 30 compressions (with 2 15 compressions

standardizati breaths in [8 seconds]) breaths in [8 seconds]) (with 2 breaths
on Purpose in [8 seconds])

Primary CPR Procedures

 Continue CPR until:
o AED arrives and starts to analyze.
o EMS personnel take over the care of the victim.
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o Reasons may switch (one rescuer / Two-Man Rescuer).

o If patient becomes conscious, please place patient in RECOVERY
POSITION.
DON'Ts in External Chest Compression:
 Rocker
 Bender
 Double Crosser
CPR with Advanced Airway (HCP ONLY)
 Cycles of 30 compressions/2 ventilations should be continued until an advanced
airway is established.
 If an advanced airway is already in place:
o Continue with chest compressions at a rate of 100-120 per minute,
without interruptions.
o Ventilation (via device) every 6 sec. (10 breaths per minute).
Recovery Position (Adult and Infant)

UNIT OF COMPETENCY II (Part B)

AUTOMATED EXTERNAL DEFIBRILLATOR (AED)
AEDs
 AEDs are sophisticated computerized devices that can analyze heart rhythm
and prompt the user to deliver a shock when necessary. These devices only
require the user to turn on the AED and follow the audio instructions provided.
AED is used to:
 Apply controlled electrical shock.
 Ensure the victim is not touching the patient and pump.
Defibrillation
A process in which an electronic device (such as AED) gives an electrical shock to the
heart. Defibrillation restores normal heart rhythm in case of Ventricular Fibrillation (VF)
or pulseless ventricular tachycardia (VT).
Defibrillation Success
 Timely rhythm recognition of VF or at least 5 seconds following shock.
 Successful recovery from successful shocks to achieve resuscitation without
neurological deficits.
Shockable Rhythms vs. Non-Shockable Rhythms
 Shockable Rhythms:
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o Ventricular Fibrillation (VF)

o Pulseless Ventricular Tachycardia (VT)
 Non-Shockable Rhythms:
o Asystole
o Pulseless Electrical Activity (PEA)
Ventricular Fibrillation (VF)
 VF is a common and treatable initial rhythm in adults with witnessed cardiac
arrest.
 Survival rates are highest when immediate bystander CPR is provided and
defibrillation occurs within 3 to 5 minutes of collapse.
 Rhythm identification should be the cornerstone of care.
 Signs of VF:
o Ventricles quivering with no blood flow.
o Myocardium is depleted of oxygen & metabolic substrates.
Pulseless Ventricular Tachycardia
 The presence of pulseless ventricular tachycardia (VT) is primarily identified by
several criteria:
o The patient is unresponsive and pulseless.
o The ECG shows VT.
Causes of VF and Cardiac Arrest
 Hypoxia
 Myocardial Ischemia
 Respiratory Failure
 Drowning
 Severe electrolyte imbalance
 Medications
 Blunt force trauma
 Carbon monoxide poisoning
Automated External Defibrillator (AED)
 Types of Ventricular Tachycardia:
o Shockable VT as indicated above.
o Non-shockable VT if certain conditions render it ineffective.
 Ensure the AED is ready to use with a fully charged battery.
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Different Types of AED

1. AED Timer
o Not capable of delivering a shock.
2. Semi-Automatic AED
o May require the operator to confirm real units.
3. Fully Automatic AED
o Automatically determines the need for a shock and will indicate when to
administer.
Several Factors That Can Affect AED Analysis
 Patient condition (e.g., supine position, gasping)
 Pacing
 Interference from other devices
Use AED Only When Victims Have the Following 3 Clinical Findings
 Unresponsive.
 No breathing.
 No pulse.
Special Conditions that Affect the Use of AED
 The patient is recently immersed in water, or water is covering the victim’s
chest.
 The presence of a metal object or other object on the surface of the patient
while using the AED may interfere.
CRITICAL CONCEPTS
The Four “STE[Sof AED Operation
1. P—POWER ON the AED.
2. A—Attach the pads to the victim's chest.
3. A—Analyze the rhythm.
4. S—Clear the victim and deliver SHOCK (if indicated).
AED PROCEDURES
1. Continue CPR until an AED is available.
2. Once the AED is available, power on the AED and follow the voice prompts.
3. Expose chest. Dry the skin or shave, if necessary.
4. Attach pads on victim’s bare chest.
Victims 8 Years of Age and Older
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 Use only adult pads (do NOT use child pads or a child key or switch for victims 8
years of age and older).
Victims 1 to 8 Years of Age
 Use child pads if available. If you do not have child pads, you may use adult
pads as long as the pads do not touch.
 If the AED has a key or switch that will deliver a child shock dose, turn the key or
switch.
5. Keep following voice prompts.
6. Once the voice prompt tells “Analyzing heart rhythm, do not touch the patient,”
make sure:
o No one touches the victim!
o Remind co-rescuers/bystanders to avoid touching the victim.
NOTE: For semi-automated AED, clear the victim and manually press analyze button.
7. Deliver a Shock (if indicated):
 If the AED prompt tells “SHOCK ADVISED”:
o Ensure no one touches the victim!
o Verbal warning to co-rescuers/ bystanders:
 “Clear!”
 Physical and hand gestures.
 Press the Shock button and resume CPR.
AED ALGORITHM
1. Once AED is available:
o Follow the Universal Steps in AED Operation (PAAS)
o Power on the AED
o Attach pads to victim’s bare chest
o Analyze heart rhythm
o Shock delivery (if indicated)
2. Rhythm:
o YES: VF or pVT
 Shock
 CPR for 2 minutes
o NO: Asystole or PEA
 CPR for 2 minutes
3. Rhythm:
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o Yes: Shockable
o NO:
 CPR for 2 minutes
4. Rhythm:
o YES:
o NO:
 CPR for 2 minutes
5. If no signs of Return of Spontaneous circulation (ROSC), go to 11 or 12:
o If ROSC, go to Post-cardiac Arrest Care.
o Consider appropriateness of continued resuscitation.
Shock First vs. CPR First
 For witnessed adult cardiac arrest when an AED is immediately available, it is
reasonable that the defibrillator be used as soon as possible.
 For adults with unmonitored cardiac arrest or for whom an AED is not
immediately available, it is reasonable that CPR be initiated while the
defibrillator equipment is being retrieved and applied and that defibrillation, if
indicated, be attempted as soon as the device is ready for use.

AED Maintenance
1. Become familiar with your AED and how it operates.
2. Check the AED for visible problems such as signs of damage.
3. Check the “ready-for-use” indicator on your AED (if so equipped) daily.
4. Perform all user-based maintenance according to the manufacturer’s
recommendations.
5. Ideally, the case carrying the AED should contain the following supplies at all
times:
o 2 sets of extra electrode pads (3 sets total)
o 2 pocket face masks
o 1 extra battery (if appropriate for your AED); some AEDs
o have batteries that last for years
o 2 disposable razors
o 5 to 10 alcohol wipes
o 1 sterile gauze pads (4X4 inches), individually wrapped
o 1 absorbent cloth towel
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o 1 pair of scissors
Remember: AED malfunctions are rare. Most AED "problems" are caused by operator
error or failure to perform recommended user-based maintenance.
UNIT OF COMPETENCY III (Part A)
RESPIRATORY ARREST AND RESCUE BREATHING
(For Health Care Providers only)
Respiratory arrest can result from a number of causes, including submersion/near-
drowning, stroke, FBAO, smoke inhalation, epiglottis, drug overdose, electrocution,
suffocation, injuries, myocardial infarction, lightning strike, and coma from any cause.
When primary respiratory arrest occurs, the heart and lungs can continue to
oxygenate.
Respiratory arrest is the condition in which breathing stops or is inadequate.
CAUSES of Respiratory Arrest
1. Obstruction
o 1.1 Anatomical Obstruction
o 1.2 Mechanical Obstruction
2. Diseases
o 2.1 Bronchitis
o 2.2 Pneumonia
o 2.3 Chronic Obstructive Pulmonary Disease (COPD) and other respiratory
illnesses.
3. Other causes of Respiratory Arrest
o 3.1 Chest compression (by physical forces).
o 3.2 Circulatory collapse.
o 3.3 Drowning.
o 3.4 Electrocution.
o 3.5 External strangulation.
o 3.6 Poisoning.
o 3.7 Suffocation.
RESCUE BREATHING
 Is a technique of breathing air into a person's lungs to supply him or her oxygen
needed to survive.
 Given to victims who are not breathing or whose breathing is inadequate but
still have a pulse.
 A crucial tool to revive the individual or keep him or her until help comes.
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WAYS TO VENTILATE THE LUNGS

1. Mouth-to-Mouth
o A quick, effective way to provide oxygen and ventilation to the victim.
2. Mouth-to-Nose
o Is recommended when it is impossible to ventilate through the victim’s
mouth. If the mouth cannot be opened (trismus), the mouth is seriously
injured, or a tight mouth-to-mouth seal is difficult to achieve.
3. Mouth-to-Mouth-and-Nose
o If the victim is an infant (1-year-old), this is the best way in delivering
ventilation by placing your mouth over the infant's mouth and nose to
create a seal.
4. Mouth-to-Stoma
o It is used if the patient has a stoma; a permanent opening that connects
the trachea directly to the front of the neck. These patients breathe only
through the stoma.
5. Mouth-to-Face Shield
o It could provide very low resistance ventilations to a patient by using a
thin and flexible plastic.
6. Mouth-to-Mask
o It could deliver ventilation to a patient by using a pocket facemask with a
one-way valve to form a seal over the patient’s nose and mouth.
7. Bag-Valve-Mouth Device
o It could deliver ventilation to a patient by using a hand-operated device
consisting of a self-inflating bag, one-way valve, facemask, and oxygen
reservoir.
SPECIAL CONSIDERATIONS
 Rescuer should avoid pressing soft tissue under the chin; this might obstruct the
airway.
 Rescuer should not use the thumb to lift the chin.
 Rescuer should not close the victim’s mouth completely (unless mouth to nose
is the technique used).
 Rescuer should provide enough air to make the chest rise and be given at a
second.

TABLE OF COMPARISON ON RESCUE BREATHING

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CAUTION: If you give breaths too quickly or with too much force, air is likely to enter
the stomach rather than the lungs. This can cause gastric inflation. Gastric inflation
frequently develops during hand-operated methods, mouth-to-mouth, or bag-mask
ventilation. Gastric inflation can result in serious complications, such as vomiting,
aspiration, or pneumonia. Rescuers can reduce the risk of gastric inflation by avoiding
giving breaths too rapidly or too forcefully.

UNIT OF COMPETENCY III (Part B)

FOREIGN BODY AIRWAY OBSTRUCTION
Foreign Body Airway Obstruction
Definition:
A condition when solid material (like chunked foods, coins, etc.), small toys, etc., are
blocking the airway.
CAUSES OF OBSTRUCTION
1. Improper chewing of large pieces of food.
2. Excessive intake of alcohol.
3. Insertion of tongue back into the throat.
4. Swallowing without chewing (poorly cut food).
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5. Children who are using small objects.

6. For smaller children—thumb-to-mouth seal unmaintained.
TWO TYPES OF OBSTRUCTION
1. Mild Obstruction:
o Partial obstruction, where the victim can still breathe, talk, or cough.
o Signs include wheezing or difficulty breathing.
2. Severe Obstruction:
o Complete obstruction, where the victim cannot breathe, talk, or cough
effectively.
o Signs include inability to breathe or make sounds; the victim may clutch
their throat.
CLASSIFICATION OF OBSTRUCTION
1. MILD OBSTRUCTION
A. Signs:
o Respiratory distress.
o Inability to cough forcefully.
o May have wheezing.
B. Rescuer Actions:
o Encourage the victim to continue spontaneous coughing and breathing
efforts.
2. SEVERE OBSTRUCTION
A. Signs:
o Poor air exchange.
o Difficulty breathing, whooping, or coughing at all.
o Inability to speak effectively, wheeze, or raise alarm.
o Universal sign of choking.

B. Rescuer Actions:
o Ask the victim if he or she is choking. If the victim nods and cannot talk,
then a severe obstruction is present.
o Activate the emergency response system and perform chest
compressions.
UNIVERSAL SIGN OF CHOKING
The universal sign of choking is when the victim clutches their neck with one or both
hands and gasps for breath.
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FINGER SWEEP
A technique recommended for relieving foreign body airway obstruction after chest
compression/thrust when the foreign body is visible in an unconscious victim.

ABDOMINAL THRUST
An emergency procedure for removing a foreign object lodged in the airway that is
preventing a person from breathing in an upright conscious victim.
REMEMBER:
Abdominal thrusts should not be used in infants under 1 year of age due to the risk of
causing injury.

Complications from Abdominal Thrusts

1. Improper application of the abdominal thrust can damage the chest, ribs, and
internal organs.
2. Victims may also suffer after administering the abdominal thrust.
3. Victim should be examined by a physician to rule out any life-threatening
complications.

5 Back Slaps and Chest Thrusts

 For conscious INFANT with foreign body airway obstruction.

Performing the Chest Thrust in Obviously Pregnant and Very Obese People
 Instead of using Abdominal Thrusts, Chest Thrusts are used.
o The fist is placed in the middle of the breastbone to perform the chest
thrust.
 If the victim is unconscious, the chest thrusts are similar to the abdominal
thrust.
Caution: If the pregnant or obese victim becomes unconscious, call for help and
perform 30 chest compressions.