In this method of rescue breathing, you inflate the casualty's
lungs with air from your lungs. This can be accomplished by blowing
air into the person's mouth. The mouth-to-mouth rescue breathing
method is performed as follows:
a. Preliminary Steps.
(1) Step ONE (081-831-1048). If the casualty is not breathing,
place your hand on his forehead, and pinch his nostrils together
with the thumb and index finger of this same hand. Let this same
hand exert pressure on his forehead to maintain the backward head-tilt and maintain an open airway. With your other hand, keep
your fingertips on the bony part of the lower jaw near the chin
and lift (Figure 2-7).
If you suspect the casualty has a neck injury and you are
using the jaw thrust technique,
close the nostrils by placing
your cheek tightly against them.3
(2) Step TWO (081-831-1042).
Take a deep breath and place your mouth (in an airtight seal)
around the casualty's mouth (Figure 2-8).
(If the injured person is small, cover both his nose and mouth
with your mouth, sealing your lips against the skin of his face.)
(3) Step THREE (081-831-1042).
Blow two full breaths into the casualty's mouth (1 to 1 1/2 seconds
per breath), taking a breath of fresh air each time before you
blow. Watch out of the corner of your eye for the casualty's chest
to rise. If the chest rises, sufficient air is getting into the
casualty's lungs. Therefore, proceed as described in step FOUR
below. If the chest does not rise, do the following (a, b,
and c below) and then attempt to ventilate again.
(a) Take corrective action immediately by reestablishing
the airway. Make sure that air is not leaking from around your
mouth or out of the casualty's pinched nose.
(b) Reattempt to ventilate.
(c) If chest still does not rise, take the necessary
action to open an obstructed airway (paragraph 2-14).
If the initial attempt to ventilate the casualty is unsuccessful,
reposition the casualty's
head and repeat rescue breathing. Improper
chin and head positioning is the most
common cause of difficulty
with ventilation. If the casualty cannot be ventilated
the head, proceed with foreign body airway obstruction maneuvers
(see Open an Obstructed Airway, paragraph 2-14).4
(4) Step FOUR (081-831-1042).
After giving two breaths which cause the chest to rise, attempt
to locate a pulse on the casualty. Feel for a pulse on the side
of the casualty's neck closest to you by placing the first two
fingers (index and middle fingers) of your hand on the groove
beside the casualty's Adam's apple (carotid pulse) (Figure 2-9).
(Your thumb should not be used for pulse taking because you may
confuse your pulse beat with that of the casualty.) Maintain the
airway by keeping your other hand on the casualty's forehead.
Allow 5 to 10 seconds to determine if there is a pulse.
(a) If a pulse is found and the casualty is breathing
--STOP; allow the casualty to breathe on his own. If possible,
keep him warm and comfortable.
(b) If a pulse is found and the casualty is not breathing,
continue rescue breathing.
*(c) If a pulse is not found, seek medically trained personnel for help.
b. Rescue Breathing (mouth-to-mouth resuscitation) (081-831-1042).
Rescue breathing (mouth-to-mouth or mouth-to-nose resuscitation)
is performed at the rate of about one breath every 5 seconds (12
breaths per minute) with rechecks for pulse and breathing after
every 12 breaths. Rechecks can be accomplished in 3 to 5 seconds.
See steps ONE through SEVEN (below) for specifics.
Seek help (medical aid), if not done previously.
(1) Step ONE. If the casualty is not breathing, pinch
his nostrils together with the thumb and index finger of the hand
on his forehead and let this same hand exert pressure on the forehead
to maintain the backward head-tilt (Figure 2-7).
(2) Step TWO. Take a deep breath and place your mouth
(in an airtight seal) around the casualty's mouth (Figure 2-8).
(3) Step THREE. Blow a quick breath into the casualty's
mouth forcefully to cause his chest to rise. If the casualty's
chest rises, sufficient air is getting into his lungs.
(4) Step FOUR. When the casualty's chest rises, remove
your mouth from his mouth and listen for the return of air from
his lungs (exhalation).
(5) Step FIVE. Repeat this procedure (mouth-to-mouth
resuscitation) at a rate of one breath every 5 seconds to achieve
12 breaths per minute. Use the following count: "one, one-thousand;
two one-thousand; three, one-thousand; four, one-thousand; BREATH;
one one-thousand" and so forth. To achieve a rate
of one breath every 5 seconds, the breath must be given on the
*(6) Step SIX. Feel for a pulse after every 12th breath.
This check should take about 3 to 5 seconds. If a pulse beat is
not found, seek medically trained personnel for help.
*(7) Step SEVEN. Continue rescue breathing until the casualty
starts to breathe on his own, until you are relieved by another
person, or until you are too tired to continue. Monitor pulse
and return of spontaneous breathing after every few minutes of
rescue breathing. If spontaneous breathing returns, monitor the
casualty closely. The casualty should then be transported to a medical treatment facility. Maintain an open airway and be prepared to resume rescue breathing if necessary.