Normally, adults breathe between 12 to 20 times a minute. Children breathe at a slightly faster rate. A respiration may be

1.present

2.absent

3.fast

4.slow

5.normal

6.shallow

7.deep

8.labored

9.painting

10.gasping

11.regular

12.irregular

13.choking

Without equipment the examination of the circulation is the pulse checking.

Normal Pulse Rates are different with age.

1.Adult - 60 to 80 beats per minute

2.Children - 80 to 120 beats per minute

3.Newborns - 120 to 160 beat per minute

The pulse may be

1.absent

2.slow

3.rapid

4.weak

5.thready

6.pounding

7.regular rhythm

8.irregular rhythm

Normally, the pupils of eyes are equal in size. They constrict equally when exposed to light. And they dilate equally when in a dark environment. Therefore, any deviation from the norm may indicate a problem. The first responder may be observe pupils which are

1.equal and react (by constricting) to light,

2.constricted,

3.dilated,

4.unequal in size,

5.fixed (do not react to light)

Normally, the skin is dry and neither hot nor cold; however, the skin may be

1.cold

2.hot

3.wet

4.clammy

5.dry

Skin color may be

1.white or pale

2.ashen

3.dusky or gray

4.red or flushed

5.blue

6.yellowish-green or jaundiced

The normal body temperature is 98.6°F or 37°C.

Cardiac arrest is recognized by pulselessness in the large arteries of the unconscious victim. The pulse should be checked at the carotid artery. This is the most accessible, reliable, and easily learned location for checking the pulse in adults and children. This artery lies in a groove created by the trachea and the large strap muscles of the neck. The rescuer locates the victim’s larynx with three fingers (the fingertips are in the same plane !). Then slides these fingers into the groove between the trachea and the muscles at the side of the neck, where the carotid pulse can be felt. The pulse area must be pressed gently to avoid compressing the artery. There are some very important rules in the evaluation of unconscious patient. Ensuring vital functions have precedence over any other interventions. The first responder should start lifesaving interventions without any delay.

To assess the presence or absence of spontaneus breathing, the rescuer should place his or her ear over the victim”s mouth and nose while maintaning an open airway. Then, while observing the victim”s chest, the rescuer should look for the chest to rise and fall, listen for air escaping during exhalation, and feel for the flow of air. If the chest does not rise and fall and no air is exhaled, the victim is breathless. This procedure should take about 15 to 20 seconds.

Foreign body airway obstruction should be considered in the differential diagnosis of any victim, especially a younger victim, who suddenly stops breathing, becomes cyanotic, and falls unconscious for no apparent reason. Foreign body obstruction of the airway usually occurs during eating. In adults, meat is the most common cause of obstruction, although a variety of of other foods and foreign bodies have been the cause of choking in children and some adults. Common factors associated with choking on food include large, poorly chewed pieces of food, elevated blood alcohol levels, and dentures.

This maneuver should be used only in the unconscious victim, never in a seizure victim. With the victim face up, the rescuer should open the victim’s mouth by grasping both the tongue and lower jaw between the thumb and fingers and lifting the mandible. This action draws the tongue away from the back of the throat and from a foreign body that may be lodged there. This alone may partially relieve the obstruction. The rescuer inserts the index finger of the other hand down along the inside of the cheek and deeply into the throat to the base of the tongue. Then a hooking action is used to dislodge the foreign body and maneuver it into the mouthsothat it can be removed. It is sometimes necessary to use the index finger to push the foreign body against the opposite side of the throat to dislodge and remove it. The rescuer must take care not to force the object deeper into the airway.