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In this section, we're going to cover two-responder adult CPR for the healthcare professional using a bag valve mask. (If you don't have a bag valve mask, a simple mask with a one-way valve will suffice.)
The advantage of having a second, fully-trained and experienced rescuer is that the two of you can share in tasks and responsibilities. Rather than one of you having to do it all on your own.
The type of rescue mask you're using doesn't change the two-responder technique when it comes to the sharing of duties; neither does the presence or absence of supplemental oxygen.
Pro Tip #1: The advantage of two -responder CPR is the alleviation of rescuer fatigue. Performing the compressions and rescue breaths yourself will begin to tire you over time and perhaps diminish the quality of CPR being administered.
The assessment phase is similar to one-responder situations, however, while one of you is assessing the scene and patient, the other can get the equipment ready to perform CPR, try to locate an AED if one isn't present, call 911 or a code, etc. Once chest compressions begin, that's when the efforts of each responder will begin to coordinate, including the important switch at the two-minute mark.
Warning: The point of two-responder CPR is to limit fatigue and maintain the delivery of high-quality CPR. So, don't negate this benefit. Be sure to coordinate a switch at the two-minute mark so neither of you are performing chest compressions for longer than two minutes without a rest.
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your bag valve mask, or rescue mask with a one-way valve (or bag valve mask when there are two responders), handy and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
Responder one:
Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart.
Pro Tip #2: Counting with the correct cadence and out loud will help you maintain a consistent rhythm. However, when there are two responders, counting out loud is even more important. It allows the other responder to anticipate the delivery of rescue breaths and the all-important switching of duties.
Responder two:
Responder one:
Responder two:
Once you reach the two-minute mark, the responder performing chest compressions will call out switch, or the agreed upon word or phrase you'll be using to coordinate a switching of duties.
Responder two, after delivering two more rescue breaths, will hand the bag valve mask to responder one, walk around the patient and get into proper position, and begin performing chest compressions, while responder one prepares to administer rescue breaths using the bag valve mask.
In older adult patients, a general decrease in pain perception may cause a different reaction to a heart attack. Older adults often suffer what is known as a silent heart attack, meaning there is a lack of common symptoms we most often associate with heart attacks – chest pain or pressure, for instance.
For these older adult patients, the symptoms of a heart attack mostly tend to include general weakness or fatigue, aches or pains in the shoulders, and indigestion and/or abdominal pain.