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Breathing: Assessments, intervention, oxygen, airway management, rescue breathing

Breathing: Assessments, intervention, oxygen, airway management, rescue breathing

Breathing is the process of inhaling and exhaling air in order to oxygenate the body's tissues. In CPR, the ability to breathe is assessed by checking for the presence of air movement, chest rise and fall, and the sound of breath. If a person is not breathing, rescue breathing may be necessary to provide oxygen to the body.

Breathing is a critical component of cardiopulmonary resuscitation (CPR). Assessing breathing, providing oxygen, and managing the airway are all important steps in providing effective CPR.

 

  • Assessment: The first step in assessing breathing is to look for signs of normal breathing, such as chest rise and fall, audible breath sounds, and visible exhaled air. If there are no signs of normal breathing, then rescue breaths should be given. It is also important to assess the patient’s color and level of consciousness. If the patient is not responding or has an abnormal skin color (e.g., pale or blue), then rescue breaths should be given immediately.
  • Intervention: If the patient is not breathing normally, then rescue breaths should be given using a bag-valve-mask device or mouth-to-mouth resuscitation technique. The rescuer should pinch the patient’s nose shut while delivering two slow breaths over one second each into the patient’s mouth with a pause between each breath. The rescuer should watch for chest rise and fall to ensure that the breath was delivered properly.
  • Oxygen can be provided during CPR by using an oxygen delivery device such as a nonrebreather mask or nasal cannula connected to an oxygen source. Oxygen delivery devices provide supplemental oxygen to help maintain adequate oxygen levels in the blood during CPR. Oxygen delivery devices can also help reduce fatigue in rescuers performing CPR for extended periods of time.
  • Airway management: Airway management involves positioning the head and neck so that air can flow freely into and out of the lungs without obstruction from tongue displacement or other blockages such as vomit or secretions from the mouth or nose. Proper head tilt/chin lift techniques should be used when opening an unconscious patient’s airway during CPR; this helps ensure that there are no obstructions blocking airflow into and out of the lungs.
  • Rescue breathing: Rescue breathing involves delivering two slow breaths over one second each into a patient’s mouth with a pause between each breath while watching for chest rise and fall to ensure that they were delivered properly. Rescue breathing can also be performed using a bag-valve-mask device which provides more consistent results than mouth-to-mouth resuscitation alone due to its ability to deliver higher volumes of air with greater accuracy than manual ventilation techniques alone can provide.
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Frequently Asked Questions

How to do the rescue breathing exactly on an unconscious adult victim?

If the victim has a pulse but not breathing, you need to open the airway by doing a head tilt, chin lift, or jaw thrust maneuver if the victim has a spine injury. Then pinch the nose shut and give the first rescue breath, lasting for 1 second. The correct ventilation rate for adults is 10 to 12 breaths per minute. Ensure the chest rises and falls with each breath.

What if the adult victim's chest doesn't rise up or down when I'm performing rescue breathing?

If the victim's chest doesn't rise when you give the first rescue breath, ensure the airway is open by doing the head tilt chin lift again before you give the 2nd rescue breath. If the chest still doesn't rise, stop giving rescue breath and perform chest compressions only. The chest compression rate for adults is 100-120 compressions per minute.

When giving an adult a rescue breath, do you give an entire full breath every time?

Yes, giving an entire full breath to an adult victim is necessary to make the chest rise and fall. But make sure that the breath you give lasts only 1 second. Excessive ventilation or going too fast could push air into the stomach, resulting in gastric insufflation. So it's important to follow the correct ventilation rate of 10 to 12 breaths per minute.

Should I perform CPR if the child is not breathing at all?

You need to assess the breathing and pulse of the child to determine what actions to give. If the child has a pulse but is not breathing, provide rescue breaths only. If the child has no pulse and is not breathing, provide CPR starting with chest compressions followed by 2 rescue breaths. If you are not trained in CPR or confident in giving rescue breathing, you can perform Hands-Only CPR.

References

American Heart Association (2020). Cardiopulmonary Resuscitation (CPR) Basics - American Heart Association - Building healthier lives free of cardiovascular diseases & stroke.. Retrieved from https://www.heart.org/en/health-topics/cardiac-arrest/cardiopulmonary-resuscitation--cpr--basics