Artificial respiration

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First Aid

Artificial respiration is a technique for providing air for a person who is not breathing on their own, but whose heart is still beating. The provider breathes into the other person's lungs, preferably with the assistance of a barrier device.

Artificial respiration is part of performing cardiopulmonary resuscitation (CPR) but is also performed separately, especially in near-drowning and similar situations. Artificial respiration is an essential skill in first aid.

Please note that this article contains advice on how to administer resuscitation. Be aware that this advise is general, and many countries have official guidelines on how this should be done - the recommended practices vary from country to country. You are advised to refer to specific guidance from your country's authorities. For example, the UK advises against carotid pulse assessment for non-healthcare personnel, see Resuscitation Guidelines 2000.

Insufflations

mouth-to-mouth insufflation. The head of the patient is tilted backward. The rescuer closes the nose with one hand, while pushing the chin downward with the other hand to keep the patient's mouth open.

Insufflation is the act of mechanically forcing air into a patient's respiratory system. In the United States and other countries, these are known simply as "rescue breaths", "breaths" or "ventilations". Insufflations must only be provided to patients in a state of respiratory arrest; do not provide insufflations to a weakly breathing patient. If you cannot detect the breath of the patient, and when reporting has been properly done, you can start artificial respiration.

Ideally, one should never blow into an unknown body for fear of projections of bodily fluids (blood, vomit, etc); thus, if you have a CPR mask, or even a cotton handkerchief, use them to protect yourself. Cheap, keyring-sized CPR masks are available in most pharmacies. However, chances are that you will find yourself unequipped; do your best with what you have.

A CPR mask. This model will allow for insufflations that prevent the rescuer from being exposed to the patient's exhaled air or body fluids (including if the patient vomits), as well as direct connection to an oxygen bottle.

Start by giving two insufflations. These can help a nearly breathing patient recover spontaneous respiration.

• Tilt back the head of the patient to extend his airways; the head will remain in this position on itself, you do not have to maintain it so.
• Open the jaw of the patient by pulling on his chin.

In some cases (like some cases of epilepsy), the muscles of the patients are so contracted that it is impossible to open the mouth. Contrary to urban legend, the patient will not "swallow" their tongue. In this situation, it may not be possible to blow into the mouth. Instead, seal the lips together and breath into the nose while keeping the head tilted back.

• Close the nose of the patient with your free hand
• Take a deep breath, put your mouth on the mouth of the patient in an airtight manner, and blow into the mouth of the patient. These breaths should be gentle and last no longer than 2 seconds to prevent air from entering the stomach.

When you have given two insufflations, check the carotid pulse of the patient, while keeping an eye on his respiration. Chances are that

• The patient might have recovered spontaneous respiration thanks to your insufflations
• The patient might be in a state of cardio-respiratory arrest

If the patient has recovered spontaneous respiration, put him in recovery position, cover him, and monitor his respiration on a regular basis until a mobile medical unit arrives.

If the patient is in a state of cardio-respiratory arrest, you will have to perform CPR.

Oxygen

Typical view of the defibrillator operator. The leader is at the head of the patient, administrating oxygen. Note how the head of the patient in secured between the leader's knees. The defibrillation patches are on.

Depending on your training and environment, you might have an oxygen first aid set at your disposal. If a patient is in a state of respiratory arrest, use a 100% mask (airtight mask) and an air balloon. This will help you ventilate the patient with pure oxygen, while "manual" insufflations will only provide about 17% oxygen to the patient.

A patient whose lungs are full of pure oxygen can stay in apnea for nearly 30 minutes (half an hour). Thus, pure oxygen is a great help which will allow you to perform urgent duty and leave the patient for a few minutes if necessary.

The task of administrating oxygen with a balloon is not very demanding, and requires only one hand. Thus, this task can advantageously be achieved by the leader of the intervention unit, who will then keep his mind free and, being at the head of the patient, have a good view of the overall situation. The head of the patient can be secured between the knees of the oxygen operator.

See also

• mechanical ventilation for a detailed discussion from the medical perspective.
• rescue breathing
• cardiopulmonary resuscitation
• medical emergency