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So we have looked at the respiratory rate
how to observe that respiratory rate

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how to count correctly, what good practice is
how to make sure that the patient is nice and still

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so now we are moving on to the unresponsive patient
so no respiratory effort really.

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It might be you that finds the patient
or it might be a colleague that alerts you

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to the fact that they are a bit converned
about a patient.

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Patient in the bed, does not look like
they are making any respiratory effort

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so I am just going to lay the bed down flat
this is now an emergency situation

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even if they are making some respiratory effort
we still need the emergency team around.

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Depending on what area you are, 
what clinical area you are, follow local policy.

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That might be shouting for help and getting 999 called
and a paramedic team on their way.

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Or it could be pulling an emergency bell
still putting an internal call out and a crash team attending.

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So whatever that is, make sure that is going on,
a colleague is doing that while you check the patient.

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Our job now is to make sure that we are 
checking the patient, the ABCD.

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We are just giving a shake, a small shake and a shout.
We shout in both ears, "Hello can you hear me?"

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Or indeed just shout their name.

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We shout in both ears so that it gives the patient
a good chance, maybe if they are deaf in one ear

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and they can't hear that we are giving them a good chance to hear

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or there might have been a trauma 
that has affected hearing in one side.

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We have still got not response
so now are are going to check in the mouth

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and see if whether there is anything
obvious that is blocking an airway.

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If there's any loose dentures or ill fitting dentures
at this point, we will take them out.

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Or anything else that we feel is an issue
so we take all of that out.

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The patient is still not making any respiratory effort
 so now we tilt the head back and a chin lift

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to open up the airway and we are listening for breath.

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The ear comes down towards the mouth, over the mouth
and we are looking down the body at the same time.

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The ear is listening for breath sounds and we are also feeling 
for any breath that might be being made, any exhalation

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and at the same time we are looking for the chest rising 
and falling, again equal but any sort of movement

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and depending on the problems with the patient
it may be that the respiration is more down towards the abdomen.

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But we are looking for any respiratory motion at all.

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And we check like this for 10 seconds

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And after 10 seconds if there is no respiratory effort
then we go into CPR.

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So that is chest compressions and it is 
30 chest compressions to 2 breaths.

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And we carry on doing that until 
the crash team get here or paramedics

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and we are told to stop or somebody takes over