Two Rescuer CPR & Bag Valve Mask

Two Rescuer CPR

Check the Scene

Key questions to ask:

  • Is it safe for me to help?
  • What happened?
  • How many patients are there?
  • Do I have my personal protective equipment ready to use?

Check the patient

Tap and shout. Is there any response? Look at the person’s chest and face. Is the patient breathing normally?

Agonal respirations are not normal breathing. They would be characterized as occasional gasps with no chest rise.

Activate EMS – Call 911

Send someone to call and tell them to come back. The caller should give dispatch the patient’s location, what happened, how many people are injured, and what is being done.

Check Pulse

Check the pulse for no more than 10 seconds.

Adult and Child– Check the carotid artery in the neck.

Infant– Check the brachial artery on the inside of the upper arm.

Adult 2 Rescuer CPR

Give 30 compressions to 2 breaths.

  • If starting together, the second rescuer can get into position to provide respirations while the primary rescuer begins compressions.
  • If primary rescuer starts CPR alone, the second rescuer should take over compressions when or she arrives.
  • After every 5 cycles of 30:2, or every 2 minutes, the compressor should call for a switch.
  • Rescuer at the head should finish 2 breaths. Then, move into position and begin compressions. The switch should take less than 10 seconds.

Child and Infant 2 Rescuer CPR

Give 15 compressions to 2 breaths.

  • If starting together, the second rescuer can get into position to provide respirations while the primary rescuer begins compressions. For a child (age 1 to approx. 12-14 years old) use 1 or 2 hands as needed for the size of child.
  • If primary rescuer starts CPR alone, the second rescuer should take over compressions when or she arrives.
  • After every 10 cycles of 15:2, or every 2 minutes, the compressor should call for a switch.
  • Rescuer at the head should finish 2 breaths. Then, move into position and begin compressions. The switch should take less than 10 seconds.
  • For infants, compressor should use the 2 thumbs hands encircling chest compression technique.

Team Approach CPR

In some rescue situations, there may only be one rescuer who can give care in the normal sequence of assessments and actions: check the scene, check the person, call 911, check pulse, give 30 compressions, give 2 breaths, prepare and use and AED.

In many situations, there is often more than one rescuer trained and willing to help. This is when the team approach should be used. This allows multiple rescuers to perform several actions simultaneously. One rescuer can be providing compressions, at the same time another is preparing the AED, at the same time another is getting ready to give breaths with a Bag Valve Mask. The primary or initial rescuer should take on the role as team leader and delegate the tasks that need to be done. With rescuers working together in this fashion, the most efficient and beneficial care will be given to the patient.

Bag Valve Mask

  • If a bag-valve mask is available attach the bag-valve mask to a source of oxygen set at 12-15 L/min. If no O2 is available, remove the residual bag reservoir at the end of the bag-valve mask and use room air.
  • Using the “C-E” method for sealing the bag-valve mask to the patient’s face, prepare to ventilate the patient. Please note that if for any reason the bag-valve ventilations are ineffective, revert to mouth-to-mask or face shield delivery method for rescue breaths.
  • Ensure that thumb and forefinger are sealing the mask at the face of the patient. With middle, ring, and pinky fingers, grab the mandible (jaw) of the patient and pull the patient’s face into the mask seal. If the mask is sealed well, there should be minimum to no air leakage on ventilation. Squeeze the bag fully so that the patient’s chest rises. When the chest rises stop squeezing the bag so to avoid over-inflation which may force the air into the stomach.
  • Ventilate at 1 breath every 5 seconds for and adult and 1 breath every 3 seconds for a child or infant, to perform rescue breathing. If an advanced airway is in place, perform 1 breath every 6-8 seconds. Take care not to hyperventilate the patient.
  • A proper size infant mask should be used. However, if only an adult size mask is available, the infant will benefit from turning an adult sized mask upside down so that the small point (nose side) covers the patient’s chin and the broad part (chin side) of the mask is covering the mouth and nose.

Jaw Thrust for Spinal Injury

If you suspect a head, Neck or back injury, do not move the person unless it is necessary to provide care for life threatening conditions. A jaw thrust can be used to open the airway.

If you are not able to open the airway adequately with the jaw thrust, use a head-tilt chin-lift to open the airway. For an unconscious, non-breathing person it is more important to have an open airway rather than consideration of a potential spinal injury.

To perform a Jaw Thrust:

  • Place hands firmly along the side of the victim’s face
  • The fingers are placed on the bottom of the jawbone
  • The thumbs are placed on the cheekbones
  • To open the airway, lift up on the bottom of the jawbone while the thumbs stay firmly on the cheekbones
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