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3-12. CONTINUE RESCUE BREATHING

If the casualty's heart is beating adequately and he is not breathing on his own, continue to administer rescue breathing. Administer ventilations (breaths) at the rate of 1 ventilation about every 5 seconds (10 to 12 ventilations per minute). Keep the casualty's airway open, while performing the ventilations and continue to monitor the casualty's pulse.

a. Perform Ventilations. Administer ventilations using the mouth-to-mouth, the mouth-to-nose, or the mouth-to-stoma method, as appropriate. Ventilations can also be provided with the bag-valve-mask or other equipment that is discussed in other subcourses. The steps given below assume that the mouth-to-mouth method is being used with the head-tilt/chin-lift. Adjust the procedures as needed if another combination is being used.

(1) Take a breath.

 

(2) Pinch the casualty's nostrils closed using the thumb and index finger of the hand on his forehead.

 

(3) Place your mouth over the casualty's mouth, making sure that a tight seal is formed.

 

(4) Blow into the casualty's mouth at a slow rate. As you blow, observe his chest. If his chest does not rise, a sufficient amount of air is not getting into his lungs. This may be caused by an inadequate positioning of his airway, by air leaking from the casualty's nose, by air leaking from around your mouth, or by the breath not being delivered with sufficient force. If a problem exists, correct the problem and continue administering ventilations.

 

(5) Remove your mouth from around the casualty's mouth and release his nose. This allows him to exhale. Remember, the casualty's airway must be kept open so he can exhale.

 

(6) Inhale and exhale a small breath for yourself if you need to do so.

 

(7) Repeat the above procedures at a rate of one ventilation every 5 seconds until you have completed 10 to 12 ventilations.

b. Recheck Pulse. Recheck the casualty's carotid pulse after every 10 to 12 breaths (about every minute). As you check his pulse, also look, listen, and feel for signs that the casualty has begun to breathe on his own.

(1) If the pulse is absent, begin administering chest compressions (Lesson 4).

 

(2) If the casualty begins breathing on his own, maintain his airway and check for other injuries. If the casualty remains unconscious, an oropharyngeal airway may be inserted. Monitor the casualty's respirations in case he stops breathing again. The casualty will need to be evacuated for further evaluation and treatment by a physician.

 

(3) If the casualty still has a pulse but is not breathing on his own, continue to administer rescue breathing and recheck the pulse, after every 12 ventilations. Continue until the casualty begins breathing on his own, you are relieved by another qualified person, you are ordered to stop, or until you are too exhausted to continue.

NOTE: In a hospital, only a physician can order that resuscitation efforts be stopped.

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