First Aid - Artificial Respiration

Victims of electrical shocks, drowning, gas poisoning or choking have difficulty in breathing and may stop breathing altogether. Artificial respiration could save their lives. Since most people die within 6 minutes after they stop breathing, artificial respiration should begin as soon as possible after the breathing difficulty is noticed.

Call for Emergency Services.

Methods of Artificial Respiration

The are three methods of artificial respiration:

1. Mouth-to-mouth/ Mouth-to-nose
2. Chest pressure arm lift (Silvester)
3. Back pressure arm lift (Holger-Nielsen)

The most practical method is the mouth-to-mouth/nose method.

Step 1: Evaluation

1. Check for responsiveness of the victim. 
2. Call for help.
3. Position the unconscious casualty so that he is lying on his back and on a firm surface. If the casualty is lying on his chest (prone position), cautiously roll the casualty as a unit so that his body does not twist (which may further complicate a neck, back or spinal injury).

Follow the following steps for rolling the victim:

1. Straighten the casualty's legs. Take the casualty's arm that is nearest to you and move it so that it is straight and above his head. Repeat procedure for the other arm.
2. Kneel beside the casualty with your knees near his shoulders (leave space to roll his body). Place one hand behind his head and neck for support. With your other hand, grasp the casualty under his far arm (See Figure above).
3. Roll the casualty toward you using a steady and even pull. His head and neck should stay in line with his back.
4. Return the casualty's arms to his side. Straighten his legs. Reposition yourself so that you are now kneeling at the level of the casualty's shoulders. However, if a neck injury is suspected, and the jaw thrust will be used, kneel at the casualty's head, looking toward his feet.

Step 2: Opening the Airway-Unconscious and Not Breathing Casualty

If there is any foreign matter visible in the victim's mouth, wipe it quickly with your fingers or cloth wrapped around your fingers.

1. Tilt the Head back so the chin is pointing upwards. The victim should be flat on his back. Pull or push the jaw into a jutting out position for removal of obstruction of the airway by moving the base of tongue away from back of throat (See figure below).
   
   
   
   
   
   
2. Open your mouth wide and place it tightly over the victim's mouth. At the same time pinch the victim's nostrils shut or close with your cheek. Or close the victim's mouth and place your mouth over the nose. Blow into the victim's mouth or nose. (Air may be blown through the victim's teeth, even if they are clenched). The first blowing method should determine whether or not obstruction exists.
   
   
   
   
3. Remove your mouth, turn your head to side and listen for the return rush of the air that indicate air exchange. Repeat the blowing effort.
   
   For the adult blow vigorously at a rate of about 12 breaths per minute. For a child, take relatively shallow breaths appropriate for the child's size, at a rate of about 20 per minute.
4. If the victim is not breathing out the air that you blew in, recheck the head and jaw position. If you still do no get air exchange, quickly turn the victim on his side and hit him sharply between the shoulder blades several times in hope of dislodging foreign matter.
   
   Again sweep you finger through the victim's mouth to remove foreign matter.
   
   If you do not wish to come in direct contact with person, you may hold a cloth over the victim's mouth or nose and breath through it. Cloth does not greatly affect the exchange of air.
5. After giving two breaths which cause the chest to rise, attempt to locate a pulse on the casualty. Feel for a pulse on the side of the casualty's neck closest to you by placing the first two fingers (index and middle fingers) of your hand on the groove beside the casualty's Adam's apple (carotid pulse). (Your thumb should not be used for pulse taking because you may confuse your pulse beat with that of the casualty.) Maintain the airway by keeping your other hand on the casualty's forehead. Allow 5 to 10 seconds to determine if there is a pulse (See Figure).
   
   

1. If a pulse is found and the casualty is breathing --STOP; allow the casualty to breathe on his own. If possible, keep him warm and comfortable.
2. If a pulse is found and the casualty is not breathing, continue rescue breathing.
3. If a pulse is not found, begin chest compression.
   1. Expose chest and find breast bone. Put the heal of one hand on breast bone and other hand on top.
   2. Compress the chest 15 times.
   

If a pulse is not found, seek medically trained personnel for help.

For infants and small children

If there is any foreign matter visible in the victim's mouth, wipe it quickly with your fingers or cloth wrapped around your fingers.

1. Place the child on his back and use the fingers of both hands to lift the lower jaw from beneath and behind, so that it juts out.
2. Place your mouth over the child mouth and nose, making a relatively leak proof seal and breathe into the child, using shallow puffs of air. The breathing rate should be about 20/minute.
   
   If you meet resistance in your blowing efforts, recheck the position of the jaw. If the air passages are still blocked, the child should be suspended momentarily by the ankles, or inverted over the arm and given two or three sharp pats between the shoulder blades, in the hope of dislodging obstructing matter.

Stopped breathing due to Suffocation

After the person starts breathing give few doses of Camphor Q directly in mouth which provides instant relief.

See Shock for more Information.

Updated on: 01 Feb 2010