Mouth-to-mask is a reliable form of ventilation
since it allows the rescuer to use two hands to create a
Follow the steps below to perform the
Step 1Place the mask around the patients
mouth and nose, using the bridge of the nose as a guide
for correct position. Proper positioning of the mask is
critical because gaps between the mask and the face
will result in air leakage.
Step 2Seal the mask by placing the heel and
thumb of each hand along the border of the mask and
compressing firmly to provide a tight seal around the
margin of the mask.
Step 3Place your remaining fingers along the
bony margin of the jaw and lift the jaw while
performing a head tilt.
Step 4Give breaths in the same sequence and at
the same rate as in mouth-to-mouth resuscitation;
observe the chest for expansion.
Sometimes during artificial ventilation, air is forced
into the stomach instead of into the lungs. The stomach
becomes distended (bulges), indicating that the airway
is blocked or partially blocked, or that ventilations are
too forceful. This problem is more common in children
but can occur with adults as well. A slight bulge is of
little worry, but a major distention can cause two serious
problems. First, it reduces lung volume: the distended
stomach forces the diaphragm up. Second, there is a
strong possibility of vomiting.
The best way to avoid gastric distention is to
position the head and neck properly and/or limit the
volume of ventilations delivered.
NOTE: THE AMERICAN RED CROSS
(ARC) STATES THAT NO ATTEMPT
SHOULD BE MADE TO FORCE AIR FROM
THE STOMACH UNLESS SUCTION
EQUIP- MENT IS ON HAND FOR
If suction equipment is ready and the patient has a
marked distention, you can turn the patient on his side
facing away from you. With the flat of your hand, apply
gentle pressure between the navel and the rib cage. Be
prepared to use suction should vomiting occur.
Cardiac arrest is the complete stoppage of heart
function. If the patient is to live, action must be taken
immediately to restore heart function. The symptoms
of cardiac arrest include absence of carotid pulse, lack
of heartbeat, dilated pupils, and absence of breathing.
A rescuer knowing how to administer
cardiopulmonary resuscitation (CPR) greatly
increases the chances of a victims survival. CPR
consists of external heart compression and artificial
ventilation. External heart compression is performed
on the outside of the chest, and the lungs are ventilated
by the mouth-to-mouth, mouth-to-nose, mouth-to-
stoma, or mouth-to-mask techniques. To be effective,
CPR must be started within 4 minutes of the onset of
cardiac arrest. The victim should be supine on a firm
CPR should not be attempted by a rescuer who has
not been properly trained. If improperly done, CPR
can cause serious damage. It must never be practiced
on a healthy individual. For training purposes, use a
training aid instead. To learn this technique, see your
medical education department or an American Heart
Association- or American Red Cross-certified
Hospital Corpsman, nurse, or physician.
The rescuer must not assume that a cardiac arrest
has occurred solely because the victim is lying on the
floor and appears to be unconscious. First, try to rouse
the victim by gently shaking the shoulders and trying
to obtain a response (e.g., loudly ask: Are you OK?).
If there is no response, place the victim supine on a
Always assume neck injuries in
unconscious patients. Kneel at a right angle to the
victim, and open the airway using the head tilt-chin lift
or jaw-thrust methods described previously. Attempt
to ventilate. If unsuccessful, reposition the head and
again attempt to ventilate. If still unsuccessful, deliver
five abdominal thrusts (Heimlich maneuver) or chest
thrusts to open the airway. Repeat the thrust sequence
until the obstruction is removed.
the airway has been opened, check for the carotid
The carotid artery is most easily found by
locating the larynx at the front of the neck and then
sliding two fingers down the side of the neck toward
you (fig. 4-13). The carotid pulse is felt in the groove
between the larynx and the sternocleidomastoid