Artificial respiration (rescue breathing)

Artificial respiration (rescue breathing) - In clients who have stopped breathing it is essential to give mouth-tomouth, mouth-to-nose, or mouth-to-mouth-and-nose ventilation until normal respiratory function is restored. If the client’s breathing and pulse have stopped cardiopulmonary resuscitation (CPR) must be initiated immediately. The procedures and rationales are given below.

ADULT
Procedure		Rationale
Check airway is clear as previously described and remove any obvious obstruction		To facilitate respirations
Check for breathing		It is dangerous to perform artificial ventilation on someone who has normal respiratory function
Look for chest movements		Absence of a rise and fall of the chest indicates absence of respiratory function
Listen for breath sounds		Absence indicates absence of respiratory function
Feel for breath on your cheek		Absence of warm blowing from the mouth indicates absence of respiratory function
Look, listen and feel for no more than 10 seconds. If the client is not breathing get help, then:		To ensure that respiration has ceased
Lie client flat on their back (supine)		To facilitate access to airways
Tilt head and lift chin (see Figure 1.1a)		To ensure tongue is lifted away from the throat, ensuring a clear airway
Pinch the client’s nose		To ensure exhaled air is forced into the lungs and not out of the nasal passages
Take a deep breath		To ensure lungs are expanded with sufficient air to ventilate the client
Place your lips securely around the client’s mouth		To ensure a good seal and prevent leakage of air
Blow into the client’s mouth for approximately 2 seconds, watching for the chest rising		Expelled air will enter client’s lung fields, providing some oxygen. The chest rising indicates that air has entered the lung fields and not the stomach
If chest fails to rise recheck position and airway		Air may be entering the stomach as opposed to the lung fields
Remove your lips from the client’s mouth and allow the chest to fall		To facilitate exhalation
Repeat at a rate of 10 breaths per minute until the client starts to breathe on their own		To sustain respiratory function
Place client in recovery position once normal respiratory function is restored		To maintain client safety
Seek assistance		To enable investigation and treatment of cause

CHILD
Procedure		Rationale
Check airway is clear as described above		To facilitate respirations
Check for breathing		It is dangerous to perform artificial ventilation on someone who has normal respiratory function
Look for chest movements		Absence of a rise and fall of the chest indicates absence of respiratory function
Listen for breath sounds		Absence indicates absence of respiratory function
Feel for breath on your cheek		Absence of warm blowing from the mouth indicates absence of respiratory function
Look, listen and feel for no more than 10 seconds. If the client is not breathing get help, then:		To ensure that respiration has ceased
Lie client flat on their back		To facilitate access to airways
Tilt head and lift chin into ‘sniffing’ position (see Figure 1.2a)		To ensure tongue is lifted away from the throat, ensuring a clear airway
Pinch the child’s nose (unless mouth-to-mouth-and-nose ventilation is to be used)		To ensure exhaled air is forced into the lungs and not out of the nasal passages
Place your lips securely around the child’s mouth (or mouth and nose in a small child)		To ensure a good seal and prevent leakage of air
Blow into the child’s mouth for approximately 1–1.5 seconds, watching for the chest rising		Expelled air will enter child’s lung fields, providing some oxygen. The chest rising indicates that air has entered the lung fields and not the stomach
If chest fails to rise recheck position and airway		Air may be entering the stomach as opposed to the lung fields
Remove your lips from the child’s mouth and allow the chest to fall		To facilitate exhalation
Repeat at a rate of 20 breaths per minute until the child starts to breathe on their own		To sustain respiratory function
Assist the child to find a comfortable position once normal respiratory function is restored		A child will often find the best position to maintain their airway and should not be forced into position which is less than comfortable
Seek assistance		To enable investigation and treatment of cause

INFANT
Procedure		Rationale
Check airway is clear as described above		To facilitate respirations
Check for breathing		It is dangerous to perform artificial ventilation on someone who has normal respiratory function
Look for chest movements		Absence of a rise and fall of the chest indicates absence of respiratory function
Listen for breath sounds		Absence indicates absence of respiratory function
Feel for breath on your cheek		Absence of warm blowing from the mouth indicates absence of respiratory function
Look, listen and feel for no more than 10 seconds. If the client is not breathing get help, then:		To ensure that respiration has ceased
Lie infant flat on their back		To facilitate access to airways
Tilt head and lift chin into neutral position (see Figure 1.3)		To ensure a clear airway
Place your lips securely around the infant’s mouth and nose		To ensure a good seal and prevent leakage of air
Blow into the infant’s mouth for approximately 1–1.5 seconds, watching for the chest rising		Expelled air will enter infant’s lung fields, providing some oxygen. The chest rising indicates that air has entered the lung fields and not the stomach
If chest fails to rise recheck position and airway		Air may be entering the stomach as opposed to the lung fields
Remove your lips from the infant’s mouth and allow the chest to fall		To facilitate exhalation
Repeat at a rate of 20 breaths per minute until the infant starts to breathe on their own		To sustain respiratory function
Assist the infant to find a comfortable position once normal respiratory function is restored		An infant will often find the best position to maintain their airway and should not be forced into position which is less than comfortable
Seek assistance		To enable investigation and treatment of cause