EAR (Expired Air Resuscitation) is used when a person has stopped breathing (respiratory arrest).
CPR (Cardiopulmonary Resuscitation) is necessary when the patient has no heart beat (cardiac arrest).
EAR and CPR can provide oxygen to the body and may restore heartbeat and breathing. They are life-saving first aid measures that everyone should learn. Without a heartbeat, the body will be deprived of oxygen. Brain damage can occur after 4 minutes without oxygen, and complete brain death is likely after 10 minutes.
WHEN TO PERFORM EAR/CPR
If you find an unconscious person, DO NOT LEAVE THEM ALONE. Shout for someone to call an ambulance. If you are alone, do not leave the person to find help until you are certain they are breathing and have a heartbeat. Remember the acronym DRABC (think Doctor, A,B,C) and follow these steps first.
D- Danger. Remove the patient from danger e.g. a fire, electricity source, pool or road.
R- Response. Shout the patient’s name, check for pain response by pinching the upper ear. If no response;
A- Airway. Turn the patient onto their side and gently scoop one finger through the mouth to clear any foreign matter away. Turn them onto their back and gently tilt the head back to open the airway. (Do not tilt the head on babies less than 1 year old.)
B- Breathing. LOOK for the rise and fall of the chest, LISTEN for breathing and FEEL for air leaving the patient’s mouth or nose. If breathing is present, turn the patient on their side again and wait for help. If there is no breathing, commence EAR.
C- Circulation. Check the carotid pulse, which is next to the Adam’s apple in the neck. If the pulse is present, continue EAR and wait for help. If the pulse is absent, begin CPR.
How to decide what they need?
- A casualty who has stopped breathing and has a pulse needs only EAR (Expired Air Resuscitation)
- A casualty who has both stopped breathing and whose has no pulse needs both EAR and CPR (Cardiopulmonary Resuscitation)
- It is not possible to be breathing if there is no pulse
- Time is critical – 4 minutes or more without oxygen can lead to brain damage
Turn the patient onto their back and open the airway by placing one hand on the forehead to tilt the head back. Support the jaw with your fingers in a ‘pistol grip’ position. Only remove dentures if they are broken or loose.
Make a tight seal around the patient’s mouth with your mouth. Close the patient’s nostrils with your cheek. For babies, cover both the nose and mouth with your mouth. Breathe steadily into the patient until you see the chest rise. Each breath should last about 1 to 2 seconds, with a pause in between to let the air flow back out. Watch the chest rise as you breathe in to ensure that your breaths are actually going into the lungs, and watch as the chest falls.
Step 1. Give 5 quick breaths in 10 seconds.
Step 2. Check for a carotid pulse after giving the 5 full breaths.
Step 3. If the casualty has a pulse but is not breathing, continue EAR. (Adults and older children need 1 breath every four seconds, 15 breaths per minute. Babies need 1 breath every 3 seconds, 20 breaths per minute.)
Step 4. Recheck the pulse and breathing every two minutes. If breathing returns, place the patient on their side and wait for the ambulance (or call one if you haven’t already).
Lie the patient completely flat on a firm surface. Kneel beside the patient. Position yourself midway between the chest and the head in order to move easily between compressions and breaths.
- Find the mid point of the breastbone (sternum).
- For adults: place the heel of your compressing hand on the breastbone just below the midpoint. Grasp your wrist with your other hand, or place the other hand on top of the first.
- For children: Use one hand only.
- For babies: Use the tips of two fingers.
For adults: Keep your shoulders directly over your hands and keep your arms straight. Lean the weight of your upper body onto your hands to compress the chest. Keep a steady, even rhythm and do not “jab” with your hands or punch the breastbone.
- For adults, compress about 4-5cm
- For children, compress about 2-3cm
- For babies, compress about 1-2cm
Each compression lasts less than one second. After each compression, release the pressure on the chest without losing contact with it and allow the chest to return to its normal position before starting the next compression.
EAR/CPR Breathing/Compression rate
If you are alone:
- For an adult, give 15 compressions followed by 2 breaths over 15 seconds
- For a child or baby, give 15 compressions and 2 breaths over 10 seconds
If there are two people:
- One person does the breathing and one does compressions
- Give 5 compressions followed by 1 breath. The person doing the compressions can count “One, two, three, four, five, BREATHE” to help maintain a rhythm
- Check pulse and breathing every two minutes
- If the pulse returns, STOP compressions immediately. Continue with EAR if there is no breathing
- If breathing and pulse return, place the patient on their side and wait for an ambulance.
St John’s Ambulance regularly holds basic first aid courses as well as advanced and specialist courses such as first aid for divers or first aid in remote areas. For more information contact St John’s Ambulance: ACT (06) 282 2399; NSW (02) 9212 5503; NT (089) 27 9111; QLD (07) 3252 3450; SA (08) 274 0347; TAS (03) 6642 7177; VIC (03) 9642 1533; WA (09) 325 4088. New Zealand (09) 579 1015.
Your pharmacy stocks a wide range of First aid kits. Ask the Pharmacist which one will best suit your needs. Always have a suitable first aid kit with you while you travel on long journeys.
First aid kits can also be put together to suit your individual needs. First Aid kit contents include:adhesive tape, alcohol wipes, bandages, adhesive strips, cotton wool balls, disinfectant, dressings, eye pads, gauze, needle, scissors, sling, sterile strips, thermometer, tweezers, antihistamine, antiseptic solution or cream, measuringcup and paracetamol. Ask your Pharmacist to help you put together a first aid kit.
First Aid training is recommended for all people. Ask your Pharmacist about First Aid training in your area.
DISCLAIMER: This information is an educational aid only. It is not intended to replace medical advice for individual conditions or treatments. Talk to your doctor, pharmacist, nurse or naturopath before following any medical regimen to see whether it is safe and effective for you.