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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.
