- gently remove any visible and easily accessible foreign objects from the mouth;
- Administer five breaths immediately, preferably using a manually operated resuscitator of the appropriate size; whilst administering the initial breaths, remain alert to any movement, coughing or resumption of normal breathing that may occur.
- start CPR immediately, repeating cycles of fifteen chest compressions followed by two rescue breaths;
- request emergency medical assistance;
- Activate the AED as soon as possible and follow the device’s instructions. If there are two or more first-aiders with an AED, one or two first-aiders should continue with chest compressions and rescue breathing, whilst the other activates the AED. If there are two first-aiders without an AED, both first-aiders should continue chest compressions and rescue breathing until reinforcements (with an AED) arrive. The AED electrodes must be applied to the victim without interrupting CPR. The interruption of chest compressions must be kept to a minimum during rescue breaths.
- continue CPR until the AED prompts you to stop;
- Resume CPR immediately after the AED has or has not delivered an electric shock, without waiting for the AED’s voice prompts.
- administer oxygen by insufflation; Oxygen must be administered to the casualty undergoing artificial ventilation as soon as possible, without delaying the initiation of resuscitation procedures.
- suction secretions, if necessary; where secretion suction is carried out, it must not delay or interrupt CPR manoeuvres or the delivery of an electric shock.
- insert an oropharyngeal airway, if necessary; An oropharyngeal airway is inserted if artificial ventilation is ineffective due to difficulty in keeping the casualty’s airways clear.
- continue the resuscitation that has been started until medical support arrives or normal breathing resumes.
To ensure effective CPR, first-aiders must take turns every two minutes. This change will be made whilst the AED is analysing the heart rhythm, provided it is in place. If the casualty begins to wake up (moves, opens their eyes and is breathing normally):
- stop chest compressions and ventilation;
- carry out a life-threatening emergency assessment and ensure constant monitoring of consciousness and breathing whilst keeping the casualty on their back;
- be prepared to resume CPR due to the high risk of a recurrence of cardiac arrest.