1-9
TWO RESCUER TECHNIQUE.—If two people trained in CPR are on the scene, one must
perform compressions while the other performs artificial ventilation. The ratio for two-person CPR is 5
compressions to 1 ventilation. One rescuer is positioned at the chest area and the other beside the victim's
head. The rescuers should be on opposite sides of the victim.
To avoid confusion, one rescuer must be designated the leader. The leader must make the
preliminary checks of the victim's vital signs and perform the initial four ventilations. The second rescuer
will perform the compressions.
When CPR is started, the compressions should be given in a constant, methodical rhythm. The
rescuer giving the compressions counts them out loud. As the fifth compression is released, the other
rescuer ventilates the victim. The compressions should be continued while ventilation is being given.
Hemorrhage
Blood is circulated throughout the body by means of three different kinds of blood vessels: arteries,
veins, and capillaries. Arteries are large vessels that carry the blood away from the heart; veins are large
vessels that carry the blood back to the heart; and capillaries form a connecting network of smaller vessels
between the arteries and the veins.
Hemorrhage (escape of blood) occurs whenever there is a break in the wall of one or more blood
vessels. In most small cuts, only capillaries are injured. Deeper wounds result in injury to veins or
arteries. Bleeding which is severe enough to endanger life seldom occurs except when arteries or veins
are cut.
The average adult body contains about 5 quarts (4.75 liters) of blood. One pint of blood can usually
be lost without harmful effect—in fact, this is the amount usually given by blood donors. However, the
loss of 2 pints (.95 liter) will usually cause shock; shock becomes greater and greater as the amount of
blood loss increases (shock will be discussed later in this chapter). If half the blood in the body is lost,
death almost always results.
Capillary blood is usually brick red in color. If capillaries are cut, the blood oozes out slowly. Blood
from veins is dark red. If a vein is cut, the blood escapes in a steady, even flow. If an artery near the
surface is cut, the blood will gush out in spurts that are synchronized with the heartbeats; but if the cut
artery is deeply buried, the bleeding will appear to be a steady stream. Arterial blood is usually bright red
in color.
In actual practice, you might find it difficult to decide whether bleeding is from a vein or an artery;
but the distinction is not usually important. The important thing to know is that bleeding must be
controlled as quickly as possible.
METHODS OF CONTROLLING BLEEDING.—The only way to stop serious bleeding is by the
application of pressure. In practically all cases, bleeding can be stopped if PRESSURE is applied
DIRECTLY TO THE WOUND. If direct pressure does not stop the bleeding, pressure should be
applied at the appropriate pressure point. In those very rare cases where bleeding is so severe that it
cannot be controlled by either of these methods, pressure can be applied by means of a tight, constricting
band called a tourniquet.
PROCEDURES.—The actual procedures you should use to stop bleeding are detailed in the
following paragraphs:
Direct Pressure.—In almost every case, bleeding can be stopped by the application of pressure
directly on the wound. Figure 1-5 is an example of direct pressure. Place a dressing (sterile or clean, if
