BACK PRESSURE ARM LIFT

1-5 The purpose of artificial ventilation is to provide a method of air exchange until natural breathing is established. Artificial ventilation should be given only when natural breathing has stopped; it must NOT be given to any person who is still breathing. Do not assume that breathing has stopped merely because a person is unconscious or because a person has been rescued from the water, from poisonous gas, or from contact with an electric wire. Remember, DO NOT GIVE ARTIFICIAL VENTILATION TO A PERSON WHO IS BREATHING NATURALLY. If the victim does not begin spontaneous breathing after you use the head or jaw tilt techniques (discussed later) to open the airway, artificial ventilation must be attempted immediately. If ventilation is inadequate, one of the "thrust" methods of clearing the airway must be performed, followed by another attempt of artificial ventilation. MOUTH-TO-MOUTH.—To perform this method of ventilation, clear the victim's mouth of obstructions (false teeth and foreign matter), place one hand under the victim's neck and the heel of the other hand on the forehead, and, using the thumb and index finger, pinch the nostrils shut. Tilt the head back to open the airway. Take a deep breath, cover the victim's mouth with your own, and blow into the victim's mouth. Then remove your mouth from the victim's to allow the victim to exhale. Observe the victim's chest for movement. If the victim has not started to breathe normally, start artificial ventilation with four quick ventilation in succession, allowing the lungs to only partially inflate. If the victim still does not respond, then you must fully inflate the victim's lungs at the rate of 12 TO 15 VENTILATIONS PER MINUTE, or ONE BREATH EVERY 5 SECONDS. MOUTH-TO-NOSE.—This type ventilation is effective when the victim has extensive facial or dental injuries or is very young, as it permits an effective air seal. To administer this method, place the heel of one hand on the victim's forehead and use the other hand to lift the jaw. After sealing the victim's lips, take a deep breath, place your lips over the victim's nose, and blow. Observe the chest for movement and place your ear next to the victim's nose to listen for, or feel, air exchange. Again, you must continue your efforts at the rate of 12 to 15 ventilation per minute, or one breath every 5 seconds, until the victim can breathe without assistance. NOTE: Sometimes during artificial ventilation, air enters the stomach instead of the lungs. This condition is called GASTRIC DISTENTION. It can be relieved by moderate pressure exerted with a flat hand between the navel and rib cage. Before applying pressure, turn the victim's head to the side to prevent choking on stomach contents that are often brought up during the process. BACK PRESSURE ARM LIFT.—This method is an alternate technique used when other methods are not possible. Place the victim on the stomach, face to one side, neck hypo-extended, with hands under the head. Quickly clear the mouth of any foreign matter. Kneel at the victim's head and place your hands on the victim's back so that the heels of the hands lie just below a line between the armpits, with thumbs touching and fingers extending downward and outward. Rock forward, keeping your arms straight, and exert pressure almost directly downward on the victim's back, forcing air out of the lungs. Then rock backward, releasing the pressure and grasping the arms just above the elbows. Continue to rock backward, pulling the arms upward and inward (toward the head) until resistance and tension in the victim's shoulders are noted. This expands the chest, causing active intake of air (inspiration). Rock forward and release the victim's arms. This causes passive exiting of air (expiration). Repeat the cycle of press, release, lift, and release 10 to 12 times a minute until the victim can breathe naturally. Cardiac Arrest and Cardiopulmonary Resuscitation Cardiac arrest is the complete stoppage of heart function. If the victim is to live, action must be taken immediately to restore heart function.