HYPOTHERMIA

If the person is unresponsive, not breathing, and suspected to e in hypothermia, follow the normal steps for CPR and take a few extra steps

• Activate EMS and begin CPR without delay if there is no pulse

• AED should not be used as normal

• Do not wait to check the victim’s temperature

• Do not wait until the victim is rewarmed to start CPR

• wet clothes should be removed from the victim to prevent further heat loss

• shield the victim from wind or cold

• if the person is breathing, rewarm and monitor the person until EMS arrives. Avoid rough movement and handle the person gently.

• Passive warming, such as warm blankets and heat packs, can be used until active warming is available with advanced medical care

PREGNANCY

• the same skills and techniques for adult CPR needs to be followed. The focus needs to be on providing high quality CPR because of potential interference with maternal resuscitation, fetal monitoring should not be undertaken during cardiac arrest in pregnancy

• because pregnant patients are more prone to hypoxia, oxygenation and airway management should be prioritized during resuscitation from cardiac arrest in pregnancy

DROWNING

Water does not need to be “pumped out” of the lungs or stomach of a drowning victim. The routine use of abdominal thrusts or other techniques to remove water from drowning victims is unnecessary, potentially dangerous, and not recommended

• the number one priority is the rescuer’s safety. The rescuer must not put himself or herself in danger to rescue a drowning victim. Do not swim out to a drowning victim. Reach out with a long object, throw something that floats, but don’t go

• the first and most important treatment of the drowning victim is ventilation. Prompt initiation of rescue breathing increases the victim’s chance of survival. Victims with only respiratory arrest usually respond after a few artificial breaths are given

• for an unresponsive, non-breathing victim, immediate bystander CPR plus early activation of the EMS system is crucial

• CPR normally begins with chest compressions in a C-A-B sequence. However, the guidelines recommend CPR for drowning victims should use the traditional A-B-C approach in view of the lack of oxygen, ie. hypoxic nature of the arrest. It would be appropriate to open the airway and given 2 breaths before starting compressions

• to use the AED, the victim needs to be out the water. However, it is only necessary to dry the chest area before applying the defibrillation pads and using the AED.

• vomiting is common in drowning victims. If vomiting occurs, turn the victim to the side and remove the vomit using your finger. continue care after airway is cleared

• passive warming, such as warm blankets and heat packs, can be used until active warming is available with advanced medical care if severe bleeding is not controlled, consider using a tourniquet

• activate EMS if severe bleeding is present, use direct pressure and apply pressure bandage. If wound is minor, wash and apply an antibiotic ointment, then bandage as needed