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                        EXTERNAL CHEST COMPRESSION
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   If Mouth To Mouth Ventilation by itself is unsuccessful and the
   casualty's heart stops, or has stopped beating, you must perform
   External Chest Compression IN CONJUNCTION with Mouth To Mouth
   Ventilation. This is because without the heart to circulate the blood,
   oxygenated blood cannot reach the casualty's brain.

                                 METHOD
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   1:  Lay the casualty on the back on a firm surface. Kneel alongside
       the casualty facing the chest and in line with the heart. Locate
       the lower half of the breastbone; find the sternal notch at the
       top and the intersection of the rib margins at the bottom. Place
       your thumbs midway between these two "landmarks" to find the
       centre.

   
   2:  Place the heel of one hand on the centre of the lower half of the 
       breastbone, keeping your fingers off the ribs. Cover this hand 
       with the heel of the other hand and lock your fingers together.
       ( See magnified diagram )


   3:  Keep your arms straight and move forwards until your arms are 
       vertical. Press down on the lower half of the breastbone 
       ( about 4 to 5cm/1½ to 2" for the average adult). Move backwards
       to release pressure. Complete 15 compressions at the rate of
       eighty compressions per minute. ( To find the right speed, count
       one..and two...and three..., and so on.)

   4:  Move back to the casualty's head and re-open the airway. Seal the
       nose and give two breaths of Mouth To Mouth Ventilation.

   5:  Continue with fifteen compressions followed by two full 
       ventilations, repeating heart check after the first minute. There-
       after every twelve cycles or three minutes.

   6:  As soon as the heartbeat returns, stop compression immediately.
       Continue Mouth To Mouth Ventilation until natural breathing is
       restored, assisting it where necessary, and adjusting it to the
       casualty's rate. Then place the casualty in the Recovery Position.
       ( See Next Page.)

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