In this Care Certificate Guide Standard 12
After reading this Care Certificate Standard 12 – Basic Life Support, you should be able to:
- Provide basic life support.
- Complete practical basic life support training that meets the Resuscitation Council UK (RCUK) guidelines.
The Care Certificate Standards detail what you must achieve and be assessed against to meet these learning outcomes.
If you have any concerns or queries, you should discuss these with your employer and/or assessor.
Basic Life Support Training and Cardiac Arrest
Your employer should provide you with practical training, so you can put the knowledge from this standard into practice to competently carry out basic life support (BLS).
They may also want to provide training that goes beyond the minimum requirements for the Care Certificate, e.g. an Automated External Defibrillator (AED) or an Emergency First Aid at Work course. Further training is not essential to meet the requirements of the Care Certificate, but it is encouraged.
You should have regular refresher training to maintain your competence. It is good practice to complete annual refresher training on BLS, but it is not mandatory for the completion of the Care Certificate.
First Aid Training
Completing this standard will not qualify you as a first aider or provide you with the necessary competence.
To become a first aider, you would need to undertake specific first aid qualifications within your workplace.
Whether you will need such qualifications will depend on:
- Your job role in health and social care.
- Your employer’s first aid needs assessment, which is similar to a risk assessment. It helps them to decide on the first aid provision and type of training required. It is a legal requirement under the Health and Safety (First-Aid) Regulations 1981.
Your employer must provide you with specific first aid training if you require it for your role.
Training and Guidance
Your practical basic life support (BLS) training should meet the latest Resuscitation Council UK (RCUK) guidelines.
The most recent set of RCUK guidelines were released in 2015. They are renewed every five years, and the next set of guidelines will be released in spring 2021.
Your training and the guidance you will need to follow will depend on the types of individuals you are caring for and supporting.
For example, if you are working with:
- Adults in health and social care, you should undertake training in adult BLS.
- Paediatric patients in health, you should undertake training in paediatric BLS.
- Newborn patients in health, you should undertake training in newborn BLS.
Your training should also meet the guidance: Cardiopulmonary Resuscitation – Standards for Clinical Practice and Training.
Why Do You Need Basic Life Support (BLS) Training?
There may be instances where an individual you are caring for and supporting becomes ill or has an accident. Some of these situations could be life-threatening and prompt action in an emergency could help save their life.
You will need to have BLS theoretical and practical training to know how to respond in the event of a life-threatening situation, such as a cardiac arrest or choking. The training should provide you with the knowledge and confidence to respond immediately.
BLS aims to provide medical aid to the casualty until the emergency services arrive. It is about buying valuable time for the individual, not treating them.
Every second counts and BLS, when performed correctly, can make the difference between life and death.
Cardiac Arrest Survival
The Resuscitation Council UK (RCUK) are national experts in resuscitation and are committed to ensuring the improvement of survival rates for in, and out of, hospital cardiac arrest.
The British Heart Foundation (BHF) funds research each year into all heart and circulatory diseases, which includes the causes of cardiac arrests.
The BHF estimates there are more than 30,000 out-of-hospital cardiac arrests (OHCAs) in the UK each year. Even when resuscitation is attempted, the overall survival rate in the UK is just 1 in 10.
Every minute without cardiopulmonary resuscitation (CPR) and defibrillation reduces the chance of survival by up to 10%. Therefore, when an individual has a cardiac arrest, every second really does count.
Knowing how to perform CPR and using a defibrillator can at least double the chances of a casualty surviving a cardiac arrest. CPR and defibrillation are vital steps in the chain of survival, and you will look at this later in the section.
There is a wealth of information on cardiac arrest from the RCUK, BHF, NHS and others, such as St John Ambulance.
What is a Cardiac Arrest?
A cardiac arrest occurs when a person’s heart suddenly stops pumping blood around their body, which results in the brain being starved of oxygen. The oxygen starvation causes them to fall into unconsciousness and stop breathing.
Without immediate treatment or medical attention, the casualty will die. Therefore, a cardiac arrest is a serious medical emergency. Calling the emergency services (999) immediately and starting CPR is vital for the casualty’s survival.
Some people think a cardiac arrest is the same as a heart attack, but this is not the case. A heart attack occurs when the blood supply to the heart muscle is cut off, which is often due to a clot in one of the coronary arteries. During a heart attack, the heart still pumps blood around the body, and the casualty will be conscious and breathing.
A heart attack is a circulation problem, whereas a cardiac arrest is an electrical problem. A heart attack can lead to the casualty having a cardiac arrest. Therefore, it is also a medical emergency, and the emergency services should be called immediately.
Signs of a Cardiac Arrest
A cardiac arrest usually happens without warning, which is known as sudden cardiac arrest (SCA).
If an individual has a cardiac arrest, they will:
- Collapse suddenly.
- Be unresponsive.
- Not be breathing or not be breathing normally (i.e. gasping noises).
Causes of a Cardiac Arrest
A life-threatening abnormal heart rhythm called ventricular fibrillation (VF) is a common cause of a cardiac arrest. VF occurs due to chaotic heart activity, and instead of the heart pumping, it quivers or ‘fibrillates’.
The main causes of heart-related cardiac arrest are:
- A heart attack caused by coronary heart disease.
- Cardiomyopathy (diseases of the heart muscle) and some inherited heart conditions.
- Congenital (present from birth) heart disease.
- Heart valve disease.
- Acute myocarditis (inflammation of the heart muscle).
Some additional causes of cardiac arrest are:
- Hypoxia, which is caused by a severe drop in oxygen levels, e.g. from drowning, choking or suffocation.
- Electrocution.
- A drug overdose.
- Severe haemorrhage (hypovolaemic shock), e.g. from losing a large amount of blood.
Importance of CPR
As you have learned, CPR is a life-saving medical procedure that is performed when a person is in cardiac arrest. It is vital for increasing the chances of survival, as it helps pump blood and oxygen around the body and to the brain when the heart can’t.
Without CPR, the casualty will die within minutes. Therefore, after phoning 999, CPR must start immediately. If a casualty is in respiratory arrest, i.e. their heart is still beating but they are not breathing, the same procedure must be followed. The person can go into cardiac arrest very quickly without CPR. You will look at CPR in more detail later on.
Basic Life Support Elements
Basic life support (BLS) describes a set of life-saving first aid techniques that are used on a casualty who is experiencing cardiac arrest, respiratory distress or an obstructed airway.
These techniques can be used by trained first-responders, healthcare providers and bystanders.
BLS comprises of the following elements:
- Cardiopulmonary resuscitation (CPR).
- Initial assessment.
- Airway maintenance and breathing.
Initial Assessment
An initial assessment should be carried out when you approach a casualty, which is called a primary survey.
This survey is a systematic process of approaching, identifying and dealing with immediate and life-threatening conditions in order of priority.
The best way to remember the primary survey is by:
| D | Danger |
| R | Response |
| A | Airways |
| B | Breathing |
| C | Call 999/ Circulation |
| D | Defibrillation |
DRABCD (Adult)
D – Danger
- Before approaching the casualty, ensure the safety of them, yourself and any bystanders.
R – Response
- Approach the casualty from their feet if possible, as this prevents hyperextension of their neck if they are responsive.
- When checking for a response, you should use the AVPU scale.
A – Airways
- Check that their airway is open and clear.
- Place the casualty on their back.
- Open their airway using the head-tilt-chin-lift method (place your hand on their forehead and gently tilt back their head. With your fingertips under the point of their chin, lift to open the airway).
B – Breathing
- After opening their airway, you should look, listen and feel for normal breathing for no more than 10 seconds. Place your ear above their mouth, looking down their body. Listen for sounds of breathing and see if you can feel their breath on your cheek. Watch to see if their chest moves.
- Note: Agonal gasps or breaths (irregular, slow and deep breaths, frequently accompanied by a characteristic snoring sound) are present in 40% of cardiac arrest victims and should not be mistaken for normal breathing. Hence a check for no more than 10 seconds. Prepare to start CPR if there are any doubts about the casualty not breathing normally.
C – Call 999/ Circulation
- If the casualty is not breathing, call 999/112 for emergency help.
- If there is someone there to help, ask them to call. If not, call yourself.
- Remain with the casualty when making the call where possible. Use the speaker function on the phone so you can communicate with the ambulance service whilst carrying out CPR.
- Send someone to get an AED if available and staff are trained to use it.
- If you’re on your own do not leave the casualty. Start CPR.
If the Casualty is Not Breathing
- Commence CPR (30 compressions and 2 rescue breaths).
- Depth of compression 5-6cm at a rate of 100-120 compressions per minute.
If the Casualty is Breathing
- If the casualty is breathing normally but still unresponsive, place them into the recovery position if safe to do so.
- Check for further injuries (conduct a secondary survey).
- Check their breathing regularly. If the casualty deteriorates or stops breathing normally, be prepared to commence CPR immediately.
Compression-only CPR
- If you are unable, not trained to, or are unwilling to give breaths, give chest compressions only.
- These should be continuous at a rate of 100 – 120 per minute for a casualty not breathing to a depth of 5-6 cm (2 to 2.5 inches).
D – Defibrillation
- If an AED arrives, switch it on and follow the spoken or visual prompts.
- An AED is used in conjunction with CPR.
AVPU scale
As you have learned, you should use the AVPU scale when checking for a response from the casualty, which can help determine their level of consciousness. AVPU is an acronym for alert, verbal, place (pain), unresponsive.
- A – Alert – is the casualty moving/talking? If no, you should proceed to V.
- V – Voice – does the casualty respond to speech? If no, you should proceed to P.
- P – Place – place your hand on the casualty’s shoulders and gently shake them. Ask loudly ‘are you alright?’. If there is no response, proceed to U.
- U – Unresponsive – assume the casualty is unresponsive.
The ‘P’ is often referred to as pain, which will depend on the scale used. Checking whether the casualty responds to minor pain can include pinching the ear lobes or fingertips.
DRABCD (Infant and child)
D – Danger
- Before approaching the child/infant, ensure the safety of them, yourself and any bystanders.
R – Response
Infant:
- Talk to the infant.
- Gently stimulate the infant.
- If a response is gained, check for further injuries (secondary survey).
- Contact the emergency services if required.
Child:
- Talk to the child.
- Gently stimulate the child and ask loudly “are you alright?”
- If a response is gained, check for further injuries (secondary survey).
- Contact the emergency services if required.
A – Airways
- Place the child/infant on their back.
- Open their airway using the head-tilt-chin-lift method (place your hand on their forehead and gently tilt back their head. With your fingertips under the point of their chin, lift to open the airway).
B – Breathing
- After opening their airway, you should look, listen and feel for normal breathing for no more than 10 seconds. Be aware of agonal/noisy gasps.
C – Call 999/ Circulation
- Call for an ambulance (999/112).
- If there is someone there to help, ask them to call. If not, call yourself.
- If you are on your own perform CPR for 1 min before going for help (5 initial rescue breaths before starting chest compressions).
- Remain with the casualty when making the call or carry the child/infant whilst summoning for help where possible. Use the speaker function on the phone so you can communicate with the ambulance service whilst carrying out CPR.
- Send someone to get an AED if available.
If the Child/Infant is Not Breathing
- Commence CPR: 5 initial rescue breaths (30 compressions 2 breaths).
- Depth of compression: 4cm for an infant, 5cm for a child at a rate of 100-120 compressions per minute.
If the Child/Infant is Breathing
- If the child/infant is breathing normally but still unresponsive, place them into the recovery position if safe to do so.
- Check for further injuries (conduct a secondary survey).
- Check their breathing regularly. If the casualty deteriorates or stops breathing normally, be prepared to commence CPR immediately.
Compression-only CPR
- For chest compressions (dependent on the size of the child).:
Infant – 2 fingers.
Child – 1 hand.
D – Defibrillation
- If an AED arrives, switch it on and follow the spoken or visual prompts.
- An AED is used in conjunction with CPR.
All About CPR and Defibrillation
CPR, which stands for cardiopulmonary resuscitation, is a potentially life-saving medical procedure that is administered to casualties who are not breathing normally with no signs of life. CPR gives a person the best chance of survival following a cardiac arrest.
CPR is a combination of chest compressions with effective rescue breaths, which:
- Artificially circulates the blood.
- Puts air into the lungs.
By doing this, you are taking over the role of the casualty’s heart and lungs by pumping blood and oxygen around their body and to their brain.
CPR can also be performed without the rescue breaths, which is known as hands-only CPR.
Your employer should arrange for CPR to be practised in a simulated environment, as part of the Care Certificate training. Theoretical CPR training alone will not provide you with the skills to perform CPR, or the competence needed to achieve your Care Certificate.
Hands-only CPR
Hands-only CPR is a form of CPR without the rescue breaths. If for any reason you are unable to give rescue breaths, you should give chest compression-only CPR (hands-only CPR). It can still increase a casualty’s chance of survival.
The British Heart Foundation (BHF) worked with Vinnie Jones in 2012 to help teach the nation how to do hands-only CPR via a television advertisement. The campaign was entitled ‘hard and fast to staying alive’, which saw Vinnie Jones performing hands-only CPR to the Bee Gees hit Stayin’ Alive.
Always follow the current RCUK guidance regarding CPR (particularly rescue breaths) during the COVID-19 outbreak, which you can find here. Your employer should update their policies and procedures, and you must always follow their advice.
The Chain of Survival
The chain of survival describes four key interrelated steps. If these steps are delivered effectively, together and in sequence, it can maximise the chances of a casualty surviving an out-of-hospital cardiac arrest.
The sequence of steps is as follows:
Early Recognition and Call for Help
- The first link in the chain is the immediate recognition of cardiac arrest and calling for help.
- Cardiac arrest can also be prevented, i.e. if a heart attack is recognised and medical treatment is received promptly.
Early Bystander CPR
- The second link is the prompt initiation of CPR to buy time.
Early Defibrillation
- The third link is performing defibrillation as soon as possible to try to restart the heart.
Post-resuscitation Care
- The fourth link is optimal post-resuscitation care to restore the quality of life.
All steps in this chain are critical for survival. Successful resuscitation can be compromised if the chain sequence is not followed or if any of the stages are weak.
CPR Chest Compressions
The depth of chest compressions and method differs depending on the age of the casualty, for example:
- Adult – place the heel of your hand on the breastbone at the centre of the person’s chest. Place your other hand on top of your first hand and interlock your fingers. Press down by 5 to 6cm (2 to 2.5 inches – similar to the short side of a credit card).
- Child (1 year to the onset of puberty) – place the heel of 1 hand on the centre of their chest and push down by 5cm (about 2 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use 2 hands if you can’t achieve a depth of 5cm using 1 hand.
- Infant (0-1 year of age) – place 2 fingers in the middle of the chest and push down by 4cm (about 1.5 inches), which is approximately one-third of the chest diameter. The quality (depth) of chest compressions is very important. Use the heel of 1 hand if you can’t achieve a depth of 4cm using the tips of 2 fingers.
Chest compressions should be at a rate of 100-120 per minute. 30 chest compressions should be administered before moving on to breaths (also known as expired air ventilation).
CPR Rescue Breaths
After completing 30 chest compressions, 2 effective breaths should be administered directly into the casualty’s mouth. Where the casualty is an infant, breathe into their mouth and nose.
Each breath should take one second to complete, and the casualty’s chest should rise as in normal breathing. This is known as effective rescue breathing.
For infants and children, 5 initial rescue breaths should be given before starting chest compressions. Then after every 30 chest compressions, at a rate of 100 to 120 a minute, 2 breaths should be given.
Each breath should take one second like the adult practice. However, after the breath, you should take your mouth away and watch for their chest to fall as air comes out. The second breath should then be administered, and this sequence should be repeated 4 times.
The RCUK guidelines detail the full procedures for chest compressions and rescue breaths:
- Infants and children – section 5, which you can find here.
- Adults – section 8 (table 1), which you can find here.
Remember to follow the current RCUK CPR COVID-19 guidance and precautions.
The Respiratory System
Breathing is essential to life, as every part of your body needs oxygen to survive. It is the respiratory system that supplies this oxygen to all parts of the body, including the brain.
Inhaled air (when we breathe in) contains a mixture of:
- Nitrogen (79%).
- Oxygen (20%).
- Other gases (1%).
Exhaled air (when we breathe out) contains a mixture of:
- Nitrogen (79%)
- Oxygen (16%)
- Carbon dioxide (4%)
- Other gases (1%).
Oxygen can create energy and there is a sufficient quantity in exhaled air to sustain the casualty. Carbon dioxide is a ‘waste product’ of energy production.
What is an Automated External Defibrillator (AED)?
Defibrillators can be manual or automatic. Manual devices tend to be used by medical specialists in hospital environments.
Automatic devices, which are commonly known as Automated External Defibrillators (AEDs) or defibs, are found in the community, workplaces and other public spaces. AEDs provided for use by members of the public are called public access defibrillators (PADs).
An AED is a device that is compact, portable, easy to use, safe and very effective. It delivers a high energy electric shock to the heart of someone who is in cardiac arrest. An AED aims to restore the heart’s electrical system to get it beating normally again (normal rhythm).
Why are AEDs Important?
As you have learned, early defibrillation is an essential link in the chain of survival when a casualty is in sudden cardiac arrest caused by ventricular fibrillation (VF).
According to the RCUK guidelines, defibrillation within 3–5 min of collapse can produce survival rates as high as 50–70%. Each minute of delay to defibrillation reduces the probability of survival to hospital discharge by 10%.
It is vital to act immediately if an individual who you are caring for and supporting is in cardiac arrest. Remember, that cardiac arrest results in the disruption and disorganisation of the heart’s normal rhythm. This means that their heart is no longer pumping blood to the brain or around the body, which affects their ability to breathe normally. That is why every second counts and delays can cost lives.
Who can use an AED?
AEDs are easy to use and will guide the operator through the process by prompts and commands.
The device will only allow the operator to deliver a shock if it is required, as it analyses the casualty’s heart rhythm once the pads have been placed on their chest. The AED will give clear instructions on how to attach the defibrillator pads.
AEDs can be used on adults or children over 1-year-old. They are not recommended on infants less than 1-year-old.
You do not have to be trained to use an AED and anyone can use one. However, defibrillator training is recommended so that you are familiar with the device and are confident to act in an emergency. A lack of training should not be a barrier to using one, as they can save a person’s life. Ask your employer about available defibrillator training.
The RCUK has a guide to Automated External Defibrillators (AEDs).
Obstructed Airways and Choking
There is the potential for individuals who you are caring for and supporting to suffer from an obstructed airway, and there are many different causes, for example:
- Foreign bodies (foods, physical contaminants and small toys).
- Allergic reactions.
- Asthma.
- Blood.
- Vomit.
- Infections.
An obstruction in the airway can result in:
- Minor or major breathing difficulties.
- Unconsciousness and unresponsiveness, in severe circumstances.
Choking may result from either a partial or complete obstruction of the airway. The severity of the blockage will determine the difficulty in breathing.
Signs of an Obstructed Airway in an Adult
If an adult has an obstructed airway, they may show some of the following signs:
- Grasping at the throat area.
- Difficulty in breathing and speaking.
- Difficulty in crying or making a noise.
- Redness of the face.
- Eyes enlarged and watering.
- Displaying distress.
According to RCUK guidance, most choking events are associated with eating and are commonly witnessed. Therefore, you must be aware of and recognise these signs.
Treatment of Choking in an Adult
No health and social care worker should carry out this type of treatment unless they have successfully completed formal practical training provided by their employer. If you have been trained, you should follow these steps.
- Suspect choking – be alert to choking, particularly if the individual is eating.
- Encourage them to cough – instruct the casualty to lean forward and cough.
- Back blows – if the obstruction remains, administer a maximum of 5 sharp back blows between the shoulder blades.
- Abdominal thrusts – if the obstruction remains, administer a maximum of 5 abdominal thrusts.
- Repeat – if the obstruction remains, continue alternating 5 back blows with 5 abdominal thrusts. Call for help.
- Call the emergency services and CPR – if the casualty becomes unresponsive:
Support the casualty carefully to the ground.
Call the emergency services (ambulance) immediately.
Start CPR with chest compressions.
You can find the full sequence of steps for choking here in Table 2.
Signs of an Obstructed Airway in an Infant or Child
Like adults, an obstruction in the airway of a child or infant can result in:
- Minor or major breathing difficulties.
- Unconsciousness and unresponsiveness, in severe circumstances.
If a child or infant has an obstructed airway, they may show some of the following signs:
- Grasping at the throat area.
- Difficulty in breathing and speaking (in the case of a child).
- Difficulty in crying or making a noise.
- Redness of the face.
- Eyes enlarged and watering.
- Displaying distress.
If the child or infant has a complete obstruction, they may show the above signs but also the following:
They may eventually become unconscious.
Their skin colour may develop a blue/grey tinge.
They will get progressively weaker.
Treatment of Choking in an Infant
If an infant who you are caring for and supporting is choking, consider the safest way to manage the situation.
For example:
- If the infant is coughing effectively, then no external manoeuvre is necessary. They should be monitored continuously.
- If the infant’s coughing is (or is becoming) ineffective, immediately shout for help and determine the infant’s level of consciousness.
If the choking infant is still conscious but has absent or ineffective coughing:
- Give back blows.
- Give chest thrusts, if back blows do not relieve choking.
Back blows and chest thrusts create an ‘artificial cough’, which increases intrathoracic (within the cavity of the chest) pressure to dislodge the foreign body.
Back Blows
As you have learned, you should give back blows if the choking infant is still conscious but has absent or ineffective coughing.
Back blows should be carried out as follows:
- Support the infant in a head-downwards, prone position (lying flat with their chest down and their back upwards). This position enables gravity to assist in the removal of a foreign body. A seated or kneeling first aider should be able to support the infant safely across their lap.
- Support the infant’s head by placing the thumb of one hand at the angle of the lower jaw, and one or two fingers from the same hand at the same point on the other side of the jaw.
- Do not compress the soft tissues under the infant’s jaw, as this will worsen the airway obstruction.
- Deliver up to 5 sharp back blows, with the heel of one hand in the middle of the back between the shoulder blades.
- The aim is to relieve the obstruction with each blow rather than to give all 5.
Chest Thrusts
If the obstruction remains after 5 sharp back blows, perform chest thrusts. Under no circumstances should you perform abdominal thrusts on an infant.
These must be replaced with chest thrusts, and you should follow these steps (only if you have been trained):
- Turn the infant into a head-downwards supine position (face up). This is achieved safely by placing your free arm along the infant’s back and encircling the occiput (back of their head) with your hand.
- Support the infant down your arm, which is placed down (or across) your thigh.
- Identify the area for chest compression (lower sternum approximately a finger’s breadth above the xiphisternum i.e. lowest part of the breastbone).
- Deliver up to 5 chest thrusts. These are similar to chest compressions, but sharper in nature and delivered at a slower rate.
- The aim is to relieve the obstruction with each thrust rather than to give all 5.
Reassessing the Infant
If the obstruction remains, and the infant is still conscious, continue the sequence of back blows and chest thrusts.
If help is still not available, call out or send for someone to assist. Under no circumstance should the infant be left at this stage.
If the infant becomes unresponsive, place them on a firm flat surface and be prepared to carry out CPR.
If the object is expelled successfully, assess the infant’s clinical condition. It may be possible that part of the object is still present in the respiratory tract, which could cause complications. If there is any doubt, seek medical assistance.
Treatment of Choking in a Child
If a child (over 1-year-old) who you are caring for and supporting is choking, consider the safest way to manage the situation.
For example:
- If the child is coughing effectively, then no external manoeuvre is necessary. They should be monitored continuously.
- If the child’s coughing is (or is becoming) ineffective, immediately shout for help and determine the child’s level of consciousness.
If the choking child is still conscious but has absent or ineffective coughing:
- Give back blows.
- Give abdominal thrusts, if back blows do not relieve choking.
Back blows and abdominal thrusts create an ‘artificial cough’, which increases intrathoracic (within the cavity of the chest) pressure to dislodge the foreign body.
Back Blows
As you have learned, you should give back blows if the choking child is still conscious but has absent or ineffective coughing.
Back blows should be carried out as follows:
- Back blows are more effective if the child is positioned head down.
- It may be beneficial to lay a small child across your knee when you administer the back blows; like you would an infant.
- Lean the child forward and support their upper chest with one hand.
- With the other hand, administer a maximum of 5 sharp back blows from behind. The heel of your hand should strike in between their shoulder blades.
Abdominal Thrusts
If the obstruction remains after back blows, and the child is still conscious, administer abdominal thrusts, which should be carried out as follows:
- Lean the child forward, whilst standing or kneeling behind them.
- Place your arms under the child’s arms and encircle their torso.
- Make a clenched fist with one hand and place it between their umbilicus (naval) and their ribcage.
- Cup the clenched fist with the other hand and thrust inwards and upwards sharply in one motion. Repeat this procedure up to 4 more times.
- Check the child between each abdominal thrust. Cease administering abdominal thrusts immediately if the obstruction is cleared.
If the obstruction remains, continue alternating 5 back blows with 5 abdominal thrusts.
Unresponsive Child and CPR
If the choking child becomes unresponsive, you must:
- Support the child carefully to the ground.
- Call the ambulance service immediately.
- Begin CPR with chest compressions.
Children should be taken to seek medical attention if they:
- Feel like they still have an object stuck in their throat, even with the obstruction cleared.
- Have received any abdominal thrusts;
- Have difficulty in swallowing
Everything You Need to Know About Record Keeping and Confidentiality
If an adult, child or infant is injured or falls ill whilst in the health and social care setting, then a record containing relevant information should be completed.
A record is typically made in the accident book, and this information is useful as it can:
- Help to identify trends.
- Help to control health and safety risks.
- Be used for reference in future first aid needs assessments.
- Prove useful for investigations.
All incidents, accidents and near misses must be recorded in health and social care settings.
Policies and Procedures
Health and social care workers may not be responsible for recording incidents, accidents and near misses. However, this will be dependent on their specific job role.
Your organisation’s policy and procedure should:
- Detail how to report an incident, accident or near miss.
- Identify the person responsible for recording and investigating.
- Identify the forms which should be used to report and record.
Always refer to your employer’s policy, procedures and forms. If you are unsure and need further clarity, you should speak to your manager.
Confidentiality
All confidential information relating to adults, children and infants in health and social care settings must be:
- Kept secure.
- Only accessible or available to people who have rights to access it.
Those who have responsibilities for the storage of records and information must be aware of their duties under the:
- Freedom of Information Act (FOI) 2000 (where relevant).
- Data Protection Act (DPA) 2018.
- UK General Data Protection Regulation (UK GDPR).
