Disabled Bath Fixtures Help Those With Physical Impairments

Whether your loved one is facing a temporary dilemma or a permanent problem, a disabled bath can help them. This room is the scene of over 200,000 accidents each year. The causes are typically slipping or falling because of slippery surfaces. Protect your loved one by installing the equipment that will keep them safer.

Disability equipment is available in a wide range of styles. The features you select should be carefully considered. Things to think about are not only the type of disability but the severity of it, too. Use non-slip mats or appliques on all tubs for safety. Tub seats will add safety because the individual can sit down safely. Installing a flexible shower head works well with the seat, because they can sit comfortably and wash. Add grab bars for even more security.

Grab bars are designed to be attached to the walls near the tub, shower or toilet. They provide a stable railing to hold when moving, sitting or standing. A slip is more easily avoided by being able to grab the railing and regain balance. For those with severe issues or for large people, ceiling hoists are an excellent way to provide secure movement.

Back surgery and arthritis can make it difficult to sit on the toilet. Adjustable toilet seats provide additional height so sitting or standing up is much easier. After surgery, it is important to eliminate any stress near the incision.

Disabled equipment is available to make life easier for your loved one. The right design for the disabled bath could even help them to achieve independent living. Find a professional who specializes in this area to get advice about the products you should have installed.


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Tips for Personal Hygiene

Maintaining personal hygiene enhances an individual’s physical and emotional wellbeing. But when an elder becomes dependent on you to keep their skin, nails, hair and mouth clean, they can experience a deep loss of independence and self-esteem. Helping them to smell fresh and look their best can be a great booster to your elder and to you. This guide provides helpful tips on how you can help an elder maintain and improve their personal hygiene.


Hygiene doesn’t just keep a person clean – it can:

1. Help keep the skin intact to fight infection and prevent injuries;
2. Remove from the skin substances in which bacteria will grow, reducing the risk of infection;
3. Keep the mouth and gums healthy, which makes eating easier and therefore promotes good nutrition;
4. Make the person more comfortable and relaxed;
5. Boost the person’s morale.

A caregiver might be called on to bathe a bed-bound elder or assist a more mobile person with their daily routine. Your home health aide, a nurse or your doctor can give you assistance and training in how to maintain personal hygiene. These suggestions should not be substituted for the advice of an expert who knows you and your elder’s medical situation. A professional may suggest specific hygiene regimens for your case.


In most cases, it is best to assist the person rather than do all the work for them. For example, if a person still has movement of their arms, they can brush their own teeth and wash their own face. This keeps them from becoming completely dependent, relieves the workload of the caregiver and helps them exercise their motor skills. Some elderly or demented people have a fear of water or showers or fight against attempts to bathe them. Address the root fear – which may be a fear of falling (install handrails), modesty (do not undress the person fully and bathe part of the body at a time), or cold (keep the person covered or partly dressed and dry each body part as you bathe it).


When bathing a person who is confined to a bed, you can ease the burden by enlisting a partner to help you or encouraging your elder to participate in the bath. To make the bath go smoothly, gather all of your supplies ahead of time and have them near the bedside. Place towels or plastic sheets around the person and on the floor. Newspapers on the floor absorb runoff and prevent you from slipping!

1. Gather all supplies ahead of time (towels, washcloth, a light cotton blanket, mild liquid soap, lotion and miscellaneous toiletries);
2. Fill a basin 2/3 full with warm water (approximately 120 degrees F.) and replace water as it cools or gets dirty;
3. Avoid drafts – close any doors or windows;
4. Always wash your hands before you start;
5. Use a light cotton blanket to cover the person during the bath to provide privacy and warmth.

An individual may not need a full bath every day. But a person’s face, underarms and private areas should be kept clean daily or on a schedule recommended by a nurse or physician. Encouraging an elder to keep themselves clean enhances their motor skills and their own sense of independence. When caring for a member of the opposite sex or a parent, both the caregiver and the care-receiver may be embarrassed. Try to be soothing and supportive
When washing a person, work on the face and upper torso first, then each side of the body from the arm and down to the leg. Use a cotton blanket or clothing to cover body parts until you are ready to wash them and after they have been washed. Then turn the person on one side so the back faces you and wash the shoulders, back and buttocks. Dry each body part to prevent chills and then gently rub in lotion to prevent drying and soothe the skin. Finish with the private areas, working from front to back with a fresh basin of warm water. Clean and dry areas well. Special handiwipes may be a convenient way to keep these areas clean, but consider their relatively high cost. Follow any special instructions provided by a doctor or nurse.

Hair Care


Keeping a person’s hair clean is difficult if they are confined to a bed or unable to get to a source of running water like a shower or sink. But you can do it with the aide of a shampoo trough that you can make or buy from a home care supply store. When shampooing in bed:

1. Gather all equipment;
2. Place absorbent towels and a waterproof sheet over a pillow;
3. Put a shampoo basin or an inflatable sink on top of this;
4. Make sure head and shoulders are at the edge of the bed;
5. Use pitchers of warm water to rinse.

Showering

1. Consider installing sturdy grab bars to help the person get in and out of the tub;
2. Apply non-slip safety mats or treads at the bottom of the tub or shower to prevent falls;
3. Place a nonskid bathmat (not a towel) on the floor in front of the shower or tub;
4. Place a shower bench or seat in the shower so the person can sit down while he/she showers;
5. Check and adjust water temperature prior to patient getting into the tub -- Never turn on hot water when the person is in the shower;
6. Do not give a bath sitting in the bathtub unless recommended by the doctor or nurse – It may be difficult to get back out.

Mouth Care

1. Raise the head of the bed unless contraindicated – otherwise, turn person on his/her side;
2. Tuck a towel under the chin;
3. Use a soft toothbrush;
4. Brushing movement should be away from the gums.

Dentures

1. Removing the upper palate – Grasp the inner and outer surfaces on both sides of the plate. Insert your forefingers over the upper edge of the plate and press until the seal breaks between the denture and the gums. Pull plate forward to remove;
2. Removing the lower plate – Grasp the inner and outer surfaces with the thumb and forefinger. Turn slightly and pull the denture up and out;
3. Cleaning dentures – Put a towel in a basin half-filled with warm water. Use a stiff brush and scrub dentures carefully with toothpaste and rinse;
4. Inserting dentures – Wet dentures with cool water. Apply even, gentle pressure on both sides of the upper palate to work it into place in the person’s mouth. Insert lower dentures last.

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Cerebral Palsy in Children: A Guide for Care

The Child With Cerebral Palsy

The most often asked questions by parents whose child has been diagnosed with cerebral palsy (CP) involves concern and anxiety about their child’s future. The parent’s of children with CP face many challenges, including emotional and physical demands. Like any parent, those of children with CP will find that optimism blended with realism is the best approach to raising any child. With support, assistance, extra time and accommodations, most children with cerebral palsy can enjoy a full and active life.

Cerebral palsy is caused by abnormalities in the fetus’ developing brain, or from injury sustained during the birthing process or soon after. Those with CP are unable to control or move their muscles in the normal way and experience effects that can range mild to moderate to severe. Mild CP may mean the child is clumsy, while moderate CP may cause the child to walk with a limp. Severe CP can impact all of the child’s abilities including learning, sensory problems, speech difficulties, bladder and bowel trouble and eating problems. The severity level of cerebral palsy is in correlation to the injury to the brain.

Learn More about the Types of Cerebral Palsy

When an infant or young child is diagnosed with a disability, their family's lives are forever changed. Meeting the challenges of a disability requires families to draw upon their inner strength and the support of other family members, grandparents, relatives, friends and co-workers. Equally important are the support and services that the family and child receive from educational and other social service agencies. There are mandated services for children with disabilities from their birth to age 21 under the Individuals with Disabilities Education Act (IDEA). IDEA was designed to enable children with disabilities to become productive members of society by equipping them with educational and social skills to help them reach their maximum potential. At specific milestones in a child’s life, state agencies work with other professionals and the child’s family to develop and implement an academic plan to help transition the child into the mainstream.

Your Child Is The Same – Just Different

The brain’s ability to adapt to new ways of working after an injury is amazing. Infants with cerebral palsy are often more slow to reach developmental milestones such as rolling over, sitting up, crawling, walking and talking. However, many of these children learn how to make their bodies work for them in other ways. For instance, an infant unable to crawl due to CP may learn how to move around by rolling from place to place.

For babies with CP, exercise is more challenging because of their limited ability to move. However, exercise with the full range of motions is critical to preventing contractures or joint limitations. Weight bearing exercises help to decrease bone loss and sensory or motor input exercises contribute to the development of the child’s cognitive skills. An exercise program can be incorporated into a parent’s daily routine through activities such as diapering, dressing and feeding. A child’s occupational and physical therapists can provide a number of useful tips to engage your child in physical and cognitive exercise.

Parents should also incorporate outdoor activities into the exercise routine since it becomes increasingly important to stimulate the child’s sensory system. It also provides the parent with an opportunity to “stop and smell the roses”. For older children, exercise often comes in the form of play. The touch and movement associated with play are important to normal tactile (touch) and vestibular (response to movement) systems. When engaging in any activity, it is important for the parent to be cognizant of their child’s needs and limitations.

Some children with CP participate in formal physical fitness programs or gym classes. Physical therapy, occupational therapy and speech-language pathology all help a child to develop stronger muscles, as well as refine motor and communications skills. In addition to therapy, special equipment and technology is available to support the unique needs of a child with CP. Splints can help a child move and use their hands, while braces support the child as the stand or walk.

With early and continued treatment, CP’s effects can be managed and reduced. Surgery, Botox injections and other medications can help to decrease the effects of cerebral palsy and new medical treatments are being researched and developed. There is also support available from physicians, therapists, psychologists, educators, healthcare and social workers who are committed to working with children with cerebral palsy.

Learn more about the Treatment of Cerebral Palsy.

Cerebral palsy clearly presents hurdles to both the family and their child. Particularly stressful milestones include the diagnosis and conflicting emotions it brings, transitioning a child of school age into specialized education, and adjusting to the social and physical turbulence of the adolescent years. As parents age, they may face a new set of concerns regarding their child’s future. However, with support, care and love, the family facing cerebral palsy has many opportunities for happiness and success.

Cerebral Palsy Articles: Disability and Discrimination

Cerebral Palsy Articles: Living with Cerebral Palsy

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12 Tips When Caring for an Elderly Loved One

How Do I Handle My Elderly Loved One Who:


1. Wants all my time and attention?Set reasonable but strict limits of when you can be available and when you can’t. Never allow yourself to be manipulated. If you never give in to demands, your parent will learn that moaning and groaning doesn’t work and will eventually stop trying. If you give in to extreme begging, they will continue to push harder and harder, knowing that you will eventually cave in.
Always use an answering machine to screen your calls and never pick up and respond if your parent is being nasty or negative. When they ask for your help in a more reasonable way, respond positively to reinforce the good behavior, telling them how proud of them you are, and how much you appreciate the way they have approached you this time. Reinforce good behavior.
Getting your loved one involved in activities will be the best thing for both of you. Call the nearest “Area Agency on Aging” to find the Senior Centers and Senior Day Care Centers nearby, and learn about enrollment and schedules. It may take a lot of coaxing and compassion to get your parent to step out of their comfort zone of being at home and to consent to go to Day Care where they don’t know anyone. Remember that any type of change can be extremely frightening for elders. The Day Care professionals are very familiar with this problem and will help you. Ask one of the administrators to call and talk to your parent a few times to develop a relationship before going.
Take your parent out for lunch and when they are in a good mood, casually stop by the Day Care to say hello to that administrator. Have an appointment set up so you can take a tour, meet the other seniors and staff, and reduce some of the anxiety. Encourage your loved one to attend no matter how much they protest. They may hate it at first, saying that everyone is too old, it’s too much effort, or they just don’t like it-but don’t give up. Eventually they’ll make new friends and look forward to all the activities. The pressure on you to entertain them will be drastically reduced.
If they cannot physically attend a Senior Center, you can hire a companion to come in and visit with them on a regular basis. This person can read to them, watch a movie, take them out for a walk or a ride, play a game, or talk about the old days, etc.
Call your local public libraries to find out about their volunteer programs. These volunteers can be very helpful by bringing printed books, audio books, movies and travel videos to the home regularly. These deliveries also provide a visitor whom your parent may enjoy talking with. 
      
2. Makes constant unreasonable demands?Focus on the positive things you can do for your parent and don’t emphasize the things that you can’t. If you continue to eventually give in to their extreme demands these behaviors will get worse. Assertively set your boundaries of what you will and won’t do ahead of time and stand firm, giving sympathy and empathy where appropriate. Don’t let your better judgment be swayed by your sense of responsibility. If their demand strikes you as illogical or irrational, BIG FLAG-it is! Call the Alzheimer’s Association to find out where your loved one can be tested for dementia. If the bad behavior stops, give positive reinforcement by acknowledging their ability to control their conduct. You may want to give a specific reward to further encourage them. If the negative behavior continues, give three warnings, use the silent treatment, then walk away.
     
3. Is inflexible, critical and negative?First, use empathy and sympathy within reasonable limits. Your parent may just need a hug or kiss at the moment and be too embarrassed to ask for the affection they crave. Instead of arguing, agree with them about how terrible something is for a short moaning session. Practice using positive phrases like, “I’m sorry you’re feeling so lousy... What can we do to cheer you up?... Let’s put on some uplifting music and talk about good things.” Resolve within yourself not to let their negative energy and insulting comments get to you. Focus on anything positive that they say, redirecting their attention to change the subject.
If the negativity continues after you’ve tried repeatedly to change the subject, tell them that you will not engage in any more negative conversation for the day. Their “negativity quotient” is used up. If you allow it to go on, giving too much sympathy, you are teaching them that the more they complain, the more attention they will get. Don’t be an enabler.
Never respond positively to any negative behavior. For example, if your loved one screams at you to hand them something, do not do it until you are asked properly. Never respond to any demanding orders, telling them that you will be happy to accommodate their request if asked nicely. If the bad behavior continues, give three warnings, use the silent treatment, and then walk away.
     
4. Complains about real or imagined physical symptoms?Set a time limit for these health “complaint” sessions. Listen, be sympathetic, and offer solutions. Then, declare the complaint time over and divert their attention to a different topic or activity. If the moaning and groaning doesn’t stop, give three warnings, use the silent treatment, then walk away.
Try a simple test to see if their symptoms might be psychosomatic or just for attention. The next time they complain of a minor ache or pain, quickly put a vitamin pill in their mouth, pretending the pill is an aspirin. See if the mysterious pain immediately goes away. Don’t tell them that their pains are not real, but privately let their doctor know what you discover.
Together, write down their symptoms in order of what bothers them the most. When you go to the doctor, see which symptoms they actually end up complaining about. Have the doctor address each issue, take notes, and cross each item off the list as they are reviewed. If your loved one is embarrassed to complain to the doctor, take charge and make sure the doctor knows all symptoms including: sleep, appetite, energy changes, memory problems, alterations in mood, inability to do basic things, incontinence, depression, anxiety and anger. Speak with the doctor in private if necessary.
Frequently bring all medications (prescriptions and all over the counter vitamins, etc.) to the doctor’s to make sure there are no interactions. When a new medicine is prescribed, ask if any specific foods and alcohol should be avoided while taking this drug. Should this drug be taken with or without food? Should this drug be taken at a certain time of day? Is it all right to continue normal activities, such as driving? All drugs have side effects, and can interact with each other and produce further complications.
Get a lock box for their medications if you have any suspicions that they are not being taking appropriately. Hide a spare key someplace in their home in case you forget or lose your key, or if someone else has to give the medications if you cannot get there.
     
5. Exhibits bizarre behavior and uses inappropriate/foul language?Bizarre or unusual behavior that is out of character is one of the first signs of dementia. Be aware and don’t dismiss these early warnings signals. Seeking help at this early stage will greatly help your loved one and reduce your frustrations.
You can still set your limits of acceptable behavior. Correct them every time inappropriate behavior occurs and when foul or embarrassing language is used. Never resort to bad language yourself as that just perpetuates it. Keep your temper under control, or walk away until you can regain it.
Role-playing can be used to teach appropriate behavior. Make it simple with specific dialogue showing them the proper way to ask for your help.“I’d appreciate it if you could hand me the television remote... I’m glad you came to see me today... Could I please have a glass of milk?”
If you are being verbally abused (“I hate you... I never want to see you again.”) never respond. Don’t let your emotions get the better of you. Change your perception and don’t escalate the problem into a screaming match or expect a rational discussion. When you are being called offensive names, do not respond. Acknowledge them only when you are being called by you correct name. Give three warnings, use the silent treatment, walk away immediately if the behavior does not stop.
      
6. Has become suspicious and paranoid?Don’t make light of it, argue, or tell them that their fears are irrational. Calmly acknowledge how awful it must be to feel that way and assure them you don’t think they are crazy. Make them feel safe, loved, and assured of your continued support. Report these symptoms with examples to their doctor. If you get an unconcerned attitude from their doctor that it’s just part of the aging process,insist on taking them to a geriatric psychiatrist for evaluation. With the proper medication, these fears may be greatly reduced.
     
7. Is experiencing increasing levels of memory loss?Call the Alzheimer’s Association and find out where you can take your loved one for evaluation right away. They are the experts at this-don’t waste time with doctors who are not. Inquire about the drugs: Aricept, Exelon and Reminyl, and Vitamin E therapy.
Display large “direction” signs with easy-to-follow instructions. “Brush Your Teeth... Turn off Stove... Keep Door Locked.” Get a large wall calendar so that they can check off the days. To help insure that medications are not forgotten or doubled, make a chart that they can check off each time they take their pills. An erasable board can work well too. It will help them remember people if you label pictures of everyone they know and put them up where they will see them. (The larger the better.) For their telephone, get one that has one-button dialing with a photo and name of the person next to the number. The use of lists, tape recorders, crossword puzzles, trivia and computer games can help exercise the memory also.
    
8. Makes up silly lies, exaggerates and cries wolf?These may all be efforts to get attention and sympathy. Understand that these actions are desperate attempts to hold onto control or a need for assurance of your continued support. They may also be craving physical affection and don’t know how to ask for it. When you recognize an obvious lie, carefully evaluate the motive behind it. Don’t get hooked into confronting them on unimportant issues. Instead, switch your perspective and let these tall tales roll off your back. Even though they are exasperating, you don’t want to become a victim yourself. It takes two to play a game, so just don’t play it.
There are times, however, when some of their attempts to control the situation cannot be overlooked. When these behaviors are constant and disruptive try behavior modification. Never respond with positive action to what you know is a manipulative lie or the lying will persist. Calmly let them know that you’re aware that they are just trying to get more attention and that you will not let it upset you. Set strict limits of what you will and won’t tolerate and let them know that you cannot be manipulated.
     
9. Prefers to stay in bed or do nothing-”waiting to die”?This could be an ulterior motive to get more attention, or it may be a sign of depression. Carefully evaluate what’s going on. Drop in unexpectedly a few times and observe their level of activity. If you suspect depression, ask their doctor to consider prescribing an anti-depressant. There is such a wide range of effective medications available today that there may be no need for them to suffer.
Then, get your parent enrolled in Senior Day Care to create a life outside of lying in bed all day. They have to have something to look forward to, friends to see, varied activities to do. You cannot supply all this stimulation yourself day after day. Go with them a few times, have lunch and introduce them to everyone to encourage the making of new friends. Additionally, many centers have a shuttle service to pick them up and bring them home.
If your parent is a “Sundowner” who wants to sleep all day and be up all night, there are a few things you can do to alter this pattern. In the morning, open all the windows and drapes to let in fresh air and sunlight; make lots of noise by turning on the radio and television, running the vacuum cleaner, dishwasher, etc.; plan activities, exercise and visitors. Getting an hour or two of sunlight daily can help regulate their circadian rhythm. Ask your doctor about Melatonin that may help them sleep at night. Make sure they are not getting any caffeine from coffee or chocolate in the evening. Also, have their doctor regularly review all of their medications to see if any may be causing daytime drowsiness. If possible, switch them to be taken at night.
    
10. Refuses to allow a cleaning person into their home?If you arrive to find their home in a deplorable condition, don’t rush to clean it. First, call Adult Protective Services and have them “drop in” to examine the condition of the home. Their report will automatically go to the local police department, so you will be visited by a police officer soon. This puts you on record with them in case you need to prove that your parent can no longer take proper care of things. Have APS say that the home must be cleaned immediately for health and safety reasons. This way, you aren’t the bad guy making changes your loved one doesn’t want.
    
11. Gets furious if something doesn’t happen at a specific time?Avoid telling them a definite time of when you will do something, or when something will happen. Give a broad window, be vague, and say that you will try to handle their request soon. Never commit to a specific time because they may tend to obsess over it. This way, it will be a pleasant thing to tell them that you have accomplished what they asked for, rather than disappointing them that you didn’t have time. Don’t lock yourself into a time frame that you may not be able to meet. You will build their trust if you don’t have to disappoint them.
    
12. Gets mad when told “No” they can’t do something?Avoid responding with a flat-out “No” to their request. Let them know that you have considered the issue and understand their viewpoint, but explain that it’s not a good idea right now. Indicate that maybe next time, or at a later date, you will be able to handle their request. Cheerfully distract their attention to something else more positive. Most of the time, they will completely forget about this request and have a different one by the next day.
Just like some children, the more some elders are told “No” they can’t do something, the more they will keep fighting to do it. It can become a test of wills for power and control. In some instances, it may be best to just let them have their way (if there is no danger). Usually they will come to the conclusion on their own that it really wasn’t such a good idea after all.

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CPR - Cardiopulmonary Resuscitation

Illustrates the proper hand position and technique for the head tilt-chin lift, breathing, and chest compressions.

Step-by-Step Adult CPR

Cardiopulmonary resuscitation (commonly known as CPR) is to be performed if you encounter an UNCONSCIOUS ADULT WHO IS NOT BREATHING AND IS UNRESPONSIVE.
Please note--this guide is no replacement for real training and real practice.


Also, please be aware of the dangers of performing CPR. Unless proper technique is utilized, a patient may come out of treatment with broken ribs or damaged internal organs.
As a general rule, the safety of the rescuer comes before that of the victim. If you are in a dangerous situation, do not hesitate to save yourself before trying to save the victim.

Checking for a Response and Activating the ERS

 Upon finding an unconscious adult, the first step is to CHECK FOR A RESPONSE. The most common method is to tap the person (vigorously, you are checking to see if they are conscious) and saying "Hey, hey, are you okay?!" Do not be gentle--this person may really be in need of your help.

Activate the ERS (Emergency Response System) by CALLING FOR HELP AND INSTRUCTING ANOTHER PERSON TO CALL 911. Do not be generic in asking someone to call (ie, "I need someone to call 911!") because it is likely that, in such a frightening situation, no one will be willing to take responsibility and make the call. Therefore, be direct--use someone's name, or say "YOU go call 911." That way there is no confusion.

Head tilt-chin lift and Look Listen Feel

After activating the ERS, the next step is to OPEN THE AIRWAY and then LOOK, LISTEN, AND FEEL.

Note: Proper CPR position--sitting on your knees with one knee by the victim's head and the other by their chest. Try not to move around much while performing CPR.

To open the airway:

1. Place side of hand on person's forehead, just above the browline, and push back gently, tilting their head back.

2. Place two fingers beneath their chin and tilt the head back futher. This helps move the jaw forward so air can pass in and out of the mouth.

The head tilt-chin lift is a difficult technique and it requires a lot of practice to do it successfully.

IF YOU SUSPECT HEAD OR NECK INJURIES, DO NOT PERFORM HEAD TILT- CHIN LIFT! This could make the victim's condition even worse. Instead:

1. Place thumb on one end of the jaw and the middle or ring finger on the other. Push the jaw forward. This opens the airway and helps to keep the tongue from covering the back of the throat.

LOOK LISTEN AND FEEL-- When you LLF, you are checking to see if the victim is breathing on their own. After performing the Head tilt-chin lift, lean down and place your ear close to the victim's mouth and nose. LOOK for a rise in the chest; LISTEN for air passing through the mouth and nose; FEEL any air passing over your face.

Proper head tilt-chin lift technique.

Preliminary RB and Checking for a Pulse

If you do not think that the victim is breathing on their own, it is time to administer preliminary rescue breathing. Make sure your head tilt-chin lift is sufficient, then create an air tight seal over the victim's mouth with your own (this is not the most pleasing aspect of CPR, but try to remember that you are saving their life). Administer TWO BREATHS, ONE SECOND EACH IN DURATION. Look for rising and falling of the chest to confirm that the breaths have not gone in.

IF TWO BREATHS DO NOT GO IN, READJUST THE HEAD TILT-CHIN LIFT AND TRY AGAIN. IF THE AIR STILL DOES NOT GO IN, THERE MAY BE AN OBSTRUCTION OF THE WINDPIPE.

After getting two breaths in, while still leant over the victim, place two fingers (any two besides the thumb) on the carotid artery on the side of the victim's neck. This artery is very prominent in most people, and can be located halfway between the ear and chin.

Place two fingers on the carotid artery (again, NOT THE THUMB--it has a pulse of its own) and apply very gentle pressure. Applying too much pressure may cut off the artery or make the pulse difficult to feel out; applying too little pressure will not allow you to feel the pulse at all.

Feel for a pulse for NO LESS THAN FIVE SECONDS AND NO MORE THAN TEN. If a distinct pulse is not found within that time, begin chest compression CPR; if a pulse is found, being rescue breathing.

The approximate position of the carotid atery.

Pulse Found--Rescue Breathing

 If a pulse is found between five and ten seconds, you are to begin rescue breathing.

The standard rate of rescue breathing in adults is ONE BREATH EVERY FIVE SECONDS FOR TWELVE CYCLES. Make sure your head tilt-chin lift is sufficient (if it is not, the windpipe will not be open properly and the air will not go in) and repeat the rescue breathing steps as described before the pulse was taken.

1. Create an air tight seal over the victim's mouth with yours.

2. Breath in over the span of one second, looking for a rise in the chest to confirm that the air has gone in.

3. Repeat Step 2 every five seconds for twelve cycles (or one minute) and then check for a pulse.

4. If PULSE IS FOUND, CONTINUE RESCUE BREATHING. If not, begin chest compression CPR.

Check for a pulse regularly between twelve-cycle sets while doing rescue breathing; if the victim's heart stops, the sooner you begin chest compressions, the better chance the victim has of surviving.

Pulse Not Found--Chest Compressions

 If a pulse is not found within five to ten seconds, BEGIN CHEST COMPRESSIONS.

Like the head tilt-chin lift, chest compressions are a difficult technique, but they can also be very dangerous to the victim.

1. Locate bottom of rib cage.

2. Trace finger up rib cage to the base of the sternum, or the xiphoid process (a small nub of bone).

3. Place heel of one hand two finger widths above the xiphoid process.

4. Lace the fingers of your other hand with those of the hand on the victim's chest. Pull back your fingers to avoid putting pressure on the victim's ribs.

5. Begin chest compressions at a rate of 100 per minute, or 30 in less than 23 seconds. Press down firmly on the chest, putting your weight over your arms. Allow for full chest recoil between compressions.

6. Finish a set of 30 compressions in less than 23 seconds, then administer two rescue breaths over a time span of one second each.

7. Repeat Step 6 four times (or for one minute) before checking for a pulse. IF PULSE IS FOUND, BEGIN RESCUE BREATHING; IF PULSE IS NOT FOUND, RESTART CHEST COMPRESSIONS.

Place your weight on top of your arms and push down with your back muscles to lessen exhaustion.

A Brief Review

 1. Check for a response and activate the ERS.

ex: "Hey, hey, are you okay?! Help, you/person's name call 911!!!"

2. Head tilt-chin lift; LOOK LISTEN AND FEEL.

3. Two rescue breaths

4. Check for a pulse

5. PULSE FOUND--begin rescue breathing at a rate of one breath per five seconds for twelve cycles, or one minute. Recheck pulse after first cycle.

5. PULSE NOT FOUND--begin chest compressions at rate of 100 per minute or 30 in less than 23 seconds for four cycles or one minute. Recheck pulse after first cycle and fourth cycle.

When is it Okay to Stop CPR?

You may stop performing CPR if and only if:

1. Another rescuer arrives and takes over.

2. The ambulance arrives.

3. The victim begins to respond (regains consciousness and is breathing normally).

4. The area in which you are working becomes dangerous (ie fire danger and the like). In this instance, try to move the victim to a safer area, but please remember that your own safety comes first.

5. You become too exhausted to continue.

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