You arrive on the scene: Check the scene for safety
1. Check the victim for consciousness. Gently tap the shoulder and shout.
2. Call 911.
3. Check for Breathing and a Pulse:
If the adult is lying on his stomach, turn him over onto his back. Put your ear close to the adult's trach. Look, listen and feel for breathing. Check for a pulse by sliding your two fingers into the groove on the side of the adult's neck as you check for signs of life for 10 seconds.
a. Suction the trach tube. If the trach has an inner cannula, remove it and suction the length of the trach tube.
b. Change the trach if it is plugged or dislodged.
c. Give two breaths to the trach, using a resuscitation bag.
Breaths Go In: Pulse, But No Breathing
Begin Rescue Breathing:
a. Place the resuscitation bag on the trach and give one breath every five seconds (count 1-1000, 2-1000, 3-1000, 4-1000, breath, etc.).
b. Recheck for signs of life every two minutes or every 24 breathes.
No Pulse, No Breathing
a. Position the heel of one hand on the center of the chest. Place the other hand on top of the other hand.
b. With elbows locked and straight, compress the chest 2 inches in depth 30 times. Give two breaths, using the resuscitation bag. Continue with 30 compressions / two breaths, 30 compressions / two breaths, etc.
Continue CPR until you see signs of life, another rescuer takes over for you or help arrives. If you witness a sudden collapse, call 911. No pulse, no breathing, begin CPR.