RESTORE BREATHING / CPR
Conditions: You see an adult who appears to be choking collapse to the ground. On a FOB, non-CBRNE, no spinal injury suspected.
Understanding This Task
This task covers the full spectrum of airway management and CPR. You progress through checking responsiveness, opening the airway, inserting an NPA, giving rescue breaths, clearing an airway obstruction, and full CPR.
CPR ratio: 30 compressions to 2 breaths, at a rate of 100/minute, depressing the sternum 1.5-2 inches. Five cycles = ~2 minutes.
NPA sizing: Measure from nostril to earlobe (or angle of jaw). Insert bevel toward septum. Never force.
Common NO-GO Mistakes
- Check pulse AFTER rescue breaths — not before
- Compressions too shallow or wrong rate (must be 100/min, 1.5-2 inches)
- Using thumb to check pulse (use index and middle fingers)
- Not looking for objects in mouth between compression cycles
- Overexaggerated or forceful breaths
Starting Configuration
Casualty: CPR mannequin (preferred) or mannequin with all extremities on hard, flat surface. Standard field uniform.
Equipment: BLS bag with multiple NPA sizes and CPR accessories (face shields).
Task Basis: 081-831-1023, 081-000-0067
Video Resources
- CPR ratio: 30 compressions to 2 breaths.
- Compressions: 100/min, 1.5-2 inches deep, full chest recoil.
- Continue CPR until: breathing/pulse returns, relieved, or physically unable.
PERFORMANCE MEASURES
0/10 GO- 1
Check for responsiveness
- Direct a specific bystander to call for medical personnel.
- Direct another to retrieve an AED.
- 2
Roll casualty onto back
- Kneel beside casualty. Raise near arm above head.
- Place hand on back of head/neck. Grasp under arm with free hand.
- Pull steadily, keeping head/neck in line with torso. Roll as single unit.
- 3
Open airway (head-tilt/chin-lift)
- Expose bare chest. Kneel at level of shoulders.
- Place hand on forehead, apply firm backward pressure.
- Lift chin with fingertips under bony part of lower jaw. Do NOT use thumb.
- 4
Check for breathing
- Place ear over mouth/nose, look toward chest.
- Look for chest rise/fall. Listen for air escaping. Feel for airflow.
- Count respirations for 15 seconds.
- 5
Insert NPA (nasopharyngeal airway)
- Select appropriate size: measure nostril to earlobe or angle of jaw.
- Lubricate the tube. Push tip of nose upward gently.
- Position bevel toward septum. Insert into nostril until flange rests. Never force — if resistance, try other nostril.
- 6
Give rescue breaths
- Insert face shield over tongue. Maintain airway, pinch nose closed (covering NPA).
- Give 2 breaths (1 second each), watching for chest rise.
- 7
Perform chest compressions to clear airway
- Locate nipple line, heel of hand on lower half of sternum. Other hand on top.
- Straight/locked elbows, shoulders directly above hands.
- 30 compressions at 100/min, depress 1.5-2 inches. Hard and fast, full chest recoil.
- Look in mouth for objects between compressions and breaths. Remove if seen.
- 8
Reopen airway and repeat breaths
- Head-tilt/chin-lift. Check breathing. Give 2 breaths watching for chest rise.
-
9
Check for pulse (5-10 seconds) CRITICAL
- Place tips of index and middle fingers in groove beside Adam's apple on side closest to you.
- Do NOT use thumb.
-
10
Perform CPR CRITICAL
- 30 compressions: Press 1.5-2 inches at 100/min (30 in ~23 seconds). Full chest recoil. Do not remove hand between compressions.
- 2 breaths (1 second each).
- Repeat for 5 cycles or 2 minutes.
- Reassess: Check pulse (3-5 sec). Check breathing (3-5 sec).
- If pulse but no breathing: give breaths at 1 every 5-6 seconds (10-12/min).
- When casualty is breathing and conscious: place in recovery position (roll onto side, hand under chin, flex upper leg).
- Continue CPR until: breathing/pulse returns, relieved by qualified person, or physically unable.