Chapter 4 Basic Life Support: Artificial Respiration 1

4.1 Respiratory Distress Respiratory distress- An abnormal condition where breathing is labored, noisy, irregular, or unusually fast or slow, or a combination of these Respiratory arrest-Total cessation of breathing or respiratory effort 2

PROGRESS CHECK 1. A victim of respiratory distress may have skin that is either pale, flushed, or ____________. (dry/hot/bluish) 2. Basic life support describes the procedures needed to ____________ in an emergency. (summon help/sustain life/reverse damage) 3. Brain cells begin to die within ____________ minutes after being deprived of oxygenated blood. 3

Victim assessment consists of four steps: 1. Determining unresponsiveness 2. Activating the EMS system 3. Positioning the victim and opening the airway 4

Head-Tilt/Chin-Lift Maneuver If you do not suspect cervical spine injury: 1. Place the tips of the fingers of one hand underneath the lower jaw on the bony part near the chin; put your other hand on the victim’s forehead and apply firm, backward pressure. 2. Bring the chin forward, supporting the jaw and tilting the head backward 3. Lift the chin so the teeth are nearly brought together; use your thumb to keep the mouth slightly open 5

If the head-tilt/chin-lift position is unsuccessful or if you suspect spine injury 1. Facing the top of the victim’s head, place your elbows on the surface on which the victim is lying, your hands at the sides of the victim’s head. 2. Grasp the jawbone on both sides where it angles up toward the victim’s ears. Move the jaw forward and upward. 3. Retract the lower lip with your thumb if the lips close. 6

Determining Breathlessness Look for the chest to rise and fall Listen for sounds of air movement at the mouth and nose Feel for the breath against your cheek 7

PROGRESS CHECK 1. The crucial first step in basic life support is ____________. (opening the airway/assessing the victim/activating the EMS system) 2. Tap the victim on the shoulder and ask if he or she is okay to determine ____________. unresponsiveness/breathlessness/arrest) 3. Before you open the airway, the victim should be in a ____________ position. (prone/supine) 4. During the head-tilt/chin-lift maneuver, maintain backward pressure on the victim’s ____________. (chin/forehead) 5. In the jaw-thrust maneuver, you bring the victim’s ____________ forward instead of tilting the head backward. (jaw/head) 6. To assess for breathlessness, ____________ for the chest to rise and fall. (feel/look) 7. To assess for breathlessness, ____________ for air escaping during exhalation. (listen/feel) 8. To assess for breathlessness, ____________ for breath against your cheek. (feel/listen) 8

Use mouth-to-nose ventilation when You can’t open the victim’s mouth The victim’s mouth is so large that you can’t seal it off with your mouth The victim has no teeth, which interferes with the formation of a good seal The victim has mouth injuries 9

Mouth-to-Stoma Ventilation 1. Remove anything covering the stoma, such as a tie, scarf, or jewelry; clear the stoma of any foreign matter. 2. NO head tilt on a victim with a stoma—simply use one hand to pinch the victim’s nose and close the victim’s mouth. Pinch off the nose between your third and fourth finger, and seal the lips with the palm of your hand. 10

Vocabulary Face shield- A barrier device that covers a victim’s mouth Face mask- A barrier device that covers a victim’s mouth and nose Inadequate breathing- Breathing that is too slow or shallow to support life Stoma- A surgical opening in the neck 11

To help prevent gastric distention: Blow only hard enough to make the chest rise. Deliver steady breaths over one second with a volume of air that makes the chest rise. Make sure the airway is open. 12

PROGRESS CHECK 1. The most effective form of artificial ventilation is ____________. (mouth-to-mouth/mouth-to-barrier/mouth-to-nose) 2. Deliver two full, slow rescue breaths, each one lasting about ____________ seconds. (2/3/4) 3. Perform rescue breathing at the rate of about ____________ breaths per minute. (10/12/14) 4. The most common cause of ventilation difficulty is ____________. (insufficient air/obstructed airway/improper positioning of the head and chin) 5. Decompress gastric distention only if you cannot ____________ because of the inflated stomach. (see the chest rise and fall/ventilate the victim) 6. If the victim is an infant or child, ventilations should be faster and more ____________. (shallow/forceful) 13

A weak, ineffective cough A high-pitched wheeze during inhalation Monitor the victim carefully, watching for the following signs of reduced air passage: A weak, ineffective cough A high-pitched wheeze during inhalation Increased strain during breathing Clutching at the throat Slight cyanosis 14

Signs of complete airway obstruction are Inability to speak, groan, cough, or cry out (the victim of a heart attack or other emergency will be able to at least whisper) Absence of breath sounds Labored use of muscles required in breathing— flared nostrils, strained neck and facial muscles Progressive restlessness, anxiety, and confusion Unresponsiveness 15

Vocabulary Gastric distention- Inflation of the stomach with air Aspiration- Breathing foreign matter into the lungs 16

17

If the Victim Is Obese or Pregnant 1. Stand behind the victim - wrap your arms around the victim’s chest 2. Position the thumb side of your fist on the middle of the breastbone 3. Seize your fist firmly with your other hand, and thrust backward sharply. Repeat 4. If the victim is or becomes unconscious, place the victim on his or her back -give distinct, separate thrusts downward and toward the head 18

PROGRESS CHECK 1. The most reliable sign of complete airway obstruction is ___________. (cyanosis/a snoring sound during breathing/complete inability to speak) 2. The Heimlich maneuver is an abdominal thrust delivered just below the ____________. (sternum/diaphragm/rib cage) 3. During the Heimlich maneuver, your thumb should be positioned slightly above the ____________. (xiphoid process/diaphragm/navel) 4. If the victim with an obstructed airway is unconscious, the victim should be positioned on the ____________. (back/side/stomach) 5. If the victim with an obstructed airway is a conscious infant, you should first do ____________. (back blows/chest thrusts/a finger sweep) 6. If the victim with an obstructed airway is an unconscious infant, you should first do ____________. (back blows/chest thrusts/a finger sweep) 19

Key Terms respiratory distress respiratory arrest inadequate breathing stoma face shield face mask gastric distention aspiration 20