How to Give CPR to an Adult With an Advanced Airway
Victims of airway injuries or illnesses may have a compromised airway in which an advanced airway (stoma) device is implanted in the trachea (windpipe). According to Shirley Shipley, health and safely programs instructor trainer for the American Red Cross, mask-to-stoma CPR does not require special certification, just modification. It is preferable, however, to have advanced CPR certification (professional rescuer) simply because fewer modifications are necessary.
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Things You'll Need
- CPR certification for the age of the victim (adult, child or infant)
- Infant resuscitation mask
- Removable mouthpiece with a one-way valve
Instructions
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Determine the Emergency
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Check to be sure it is safe for you to approach the victim.
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2
Determine if the victim is conscious by tapping him or calling his name.
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3
If the victim does not respond, gently roll him on his back.
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4
Hold the victim's airway at neutral (head level with the chin at 90 degrees) position.
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Check for breathing and signs of life by placing your ear above the stoma---feeling and listening for breathing while looking down the body to see if the chest rises---for no more than 10 seconds.
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If it is an infant child, check for a pulse.
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If the victim is not breathing, call 911.
Give CPR
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Insert the one-way valve into the infant resuscitation mask.
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Form a seal over the advanced airway (stoma) with the mask while holding the mouth and nose closed.
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Place your mouth over the mouthpiece and give two rescue breaths of one-second duration. Blow just hard enough to make the chest clearly rise. If the breaths do not go in, adjust the airway and the mask's seal and give two more rescue breaths.
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Move hands to the compression position: heel of lower hand on the center of the breast-bone, second hand on top and the fingers laced. Lean directly over the victim, stiffen arms and press straight down (compress) at the rate of 100 bpm (e.g. count: one-and, two-and ... ). For adults, compress 30 times to a depth of one and one-half to two inches. For children, compress 15 times to a depth of one to one and one-half inches. For infants, compress using two or three-fingers 15 times at a depth of one-half to one inch.
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Give two breaths, then continue with 15 or 30 compressions. Each combination of two breaths and 15 or 30 compressions is a cycle. Continue CPR cycles until emergency personnel arrive and take over.
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Tips & Warnings
When taking CPR courses, let the instructor know you need advanced airway CPR instruction. Learn and practice the use of the infant resuscitation mask. Holding the nose and mouth closed with one hand while forming a seal with the mask requires practice on a manikin.
If a mask is not available, seal the mouth directly over the stoma.
Get training by a certified CPR instructor to avoid accidental injury to the victim. Always have a breathing barrier or resuscitation mask available. Do not leave the victim to find a barrier or mask: in that case, give mouth-to-stoma rescue breathing. Once begun, do not stop giving CPR cycles unless you are too exhausted to continue or until the scene becomes unsafe.
