the heel of the other hand on the forehead, using the thumb and index finger to pinch the nostrils shut. Tilt the head back to open the airway. If there is no spontaneous breathing, start artificial ventilation with two ventilations, allowing the lungs to deflate. If the victim still does not respond, then you must fully inflate the lungs at the rate of 12 VENTILATIONS PER MINUTE OR ONE BREATH EVERY 5 SECONDS. See figure 4-10 for the proper position. Periodically, check the pupils for reaction to light; constriction is a sign of adequate oxygenation. For infants, seal both the mouth and nose with your mouth. Blow puffs from your cheeks to prevent lung damage. Mouth-to-mouth ventilation can be administered with the jaw thrust.
Mouth-to-Nose
Mouth-to-nose ventilation is effective when the victim has extensive facial or dental injuries; this 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, start artificial ventilation with two breaths, allowing the lungs to deflate. If the victim does not respond, then you must fully inflate the lungs at the rate of 12 ventilations per minute or one breath every 5 seconds until the victim can breathe spontaneously.
Figure 4-11.—Back pressure arm lift.
Back-Pressure Arm-Lift
The back-pressure arm-lift method is a less effective technique used when other methods are not feasible, such as on a battlefield where gas masks must be worn. Place the victim in the prone position, face to one side, and neck hyperextended with the hands under the head. Quickly clear the mouth of any foreign matter. Kneel at the victim’s head and place your hands on the back so that the heels of your hands lie just below a line between the armpits, with thumbs touching and fingers extending downward and outward (fig. 4-11). 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 arm just above the elbows. Continue to rock backward, pulling the arms upward and inward (toward the head) until resistance and tension in the 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 12 times a minute until the victim can breathe spontaneously.
Mask-to-Mask
Certain types of gas masks for use in a contaminated environment, such as on a battlefield after a chemical or biological warfare attack, are equipped to allow a corpsman to give a victim artificial ventilation without either the corpsman
