11

Chapter 4Chapter 4Basic Life Support:Basic Life Support:

Artificial RespirationArtificial Respiration

22

4.1 Respiratory Distress 4.1 Respiratory Distress

Respiratory distress- Respiratory distress- An abnormal condition An abnormal condition where breathing is labored, noisy, irregular, or where breathing is labored, noisy, irregular, or unusually fast or slow, or a combination of theseunusually fast or slow, or a combination of these

Respiratory arrest-Respiratory arrest-Total cessation of breathing or Total cessation of breathing or respiratory effortrespiratory effort

33

PROGRESS CHECKPROGRESS CHECK

1. 1. A victim of respiratory distress may have skin A victim of respiratory distress may have skin that isthat is

either pale, flushed, or ____________. either pale, flushed, or ____________. (dry/hot/bluish)(dry/hot/bluish)2. 2. Basic life support describes the procedures Basic life support describes the procedures

neededneededto ____________ in an emergency.to ____________ in an emergency.(summon help/sustain life/reverse damage)(summon help/sustain life/reverse damage)3. 3. Brain cells begin to die within ____________ Brain cells begin to die within ____________

minutesminutesafter being deprived of oxygenated blood.after being deprived of oxygenated blood.

44

Victim assessment consists Victim assessment consists of four steps:of four steps:

1. 1. Determining unresponsivenessDetermining unresponsiveness

2. 2. Activating the EMS systemActivating the EMS system

3. 3. Positioning the victim and opening Positioning the victim and opening the airwaythe airway

55

Head-Tilt/Chin-Lift Head-Tilt/Chin-Lift ManeuverManeuver

If you do If you do not not suspect cervical spine injury: suspect cervical spine injury:

1.1. Place the tips of the fingers of one hand Place the tips of the fingers of one hand underneath the lower jaw on the bony part near underneath the lower jaw on the bony part near the chin; put your other hand on the victim’s the chin; put your other hand on the victim’s forehead and apply firm, backward pressure.forehead and apply firm, backward pressure.

2. Bring the chin forward, supporting the jaw and 2. Bring the chin forward, supporting the jaw and tilting the head backwardtilting the head backward

3. Lift the chin so the teeth are nearly brought 3. Lift the chin so the teeth are nearly brought together; use your thumb to keep the mouth together; use your thumb to keep the mouth slightly openslightly open

66

If the head-tilt/chin-lift position is If the head-tilt/chin-lift position is unsuccessful or unsuccessful or ifif

you suspect spine injuryyou suspect spine injury

1. Facing the top of the victim’s head, place 1. Facing the top of the victim’s head, place your elbows on the surface on which the your elbows on the surface on which the victim is lying, your hands at the sides of victim is lying, your hands at the sides of the victim’s head.the victim’s head.

2. Grasp the jawbone on both sides where it 2. Grasp the jawbone on both sides where it angles up toward the victim’s ears. Move angles up toward the victim’s ears. Move the jaw forward and upward.the jaw forward and upward.

3. Retract the lower lip with your thumb if 3. Retract the lower lip with your thumb if the the

lips close.lips close.

77

Determining Determining BreathlessnessBreathlessness

LookLook for the chest to rise and fallfor the chest to rise and fall ListenListen for sounds of air movement for sounds of air movement

at the mouth and noseat the mouth and nose Feel Feel for the breath against your for the breath against your

cheekcheek

88

PROGRESS CHECKPROGRESS CHECK

1. The crucial first step in basic life support is ____________.1. The crucial first step in basic life support is ____________.(opening the airway/assessing the victim/activating the EMS (opening the airway/assessing the victim/activating the EMS

system)system)2. Tap the victim on the shoulder and ask if he or she is okay to 2. Tap the victim on the shoulder and ask if he or she is okay to

determine ____________. determine ____________. unresponsiveness/breathlessness/arrest)unresponsiveness/breathlessness/arrest)3. Before you open the airway, the victim should be in a 3. Before you open the airway, the victim should be in a

____________ position. ____________ position. (prone/supine)(prone/supine)4. During the head-tilt/chin-lift maneuver, maintain backward 4. During the head-tilt/chin-lift maneuver, maintain backward

pressure on the victim’s ____________. pressure on the victim’s ____________. (chin/forehead) (chin/forehead) 5. In the jaw-thrust maneuver, you bring the victim’s ____________ 5. In the jaw-thrust maneuver, you bring the victim’s ____________

forward instead of tilting the head forward instead of tilting the head backward. backward. (jaw/head) (jaw/head)

6. To assess for breathlessness, ____________ for the chest to rise 6. To assess for breathlessness, ____________ for the chest to rise and fall. and fall. (feel/look)(feel/look)

7. To assess for breathlessness, ____________ for air escaping during 7. To assess for breathlessness, ____________ for air escaping during exhalation. exhalation. (listen/feel)(listen/feel)

8. To assess for breathlessness, ____________ for breath against 8. To assess for breathlessness, ____________ for breath against your cheek. your cheek. (feel/listen)(feel/listen)

99

Use mouth-to-nose Use mouth-to-nose ventilation whenventilation when

You can’t open the victim’s mouthYou can’t open the victim’s mouth The victim’s mouth is so large that The victim’s mouth is so large that

you can’t seal it off with your mouthyou can’t seal it off with your mouth The victim has no teeth, which The victim has no teeth, which

interferes with the formation of a interferes with the formation of a good sealgood seal

The victim has mouth injuriesThe victim has mouth injuries

1010

Mouth-to-Stoma Mouth-to-Stoma VentilationVentilation

1.1. Remove anything covering the stoma, Remove anything covering the stoma, such as a tie, scarf, or jewelry; clear the such as a tie, scarf, or jewelry; clear the stoma of any foreign matter.stoma of any foreign matter.

2. NO head tilt on a victim with a stoma—2. NO head tilt on a victim with a stoma—simply use one hand to pinch the victim’s simply use one hand to pinch the victim’s nose and close the victim’s mouth. Pinch nose and close the victim’s mouth. Pinch off the nose between your third and fourth off the nose between your third and fourth finger, and seal the lips with the palm of finger, and seal the lips with the palm of your hand.your hand.

1111

VocabularyVocabulary

Face shield-Face shield- A barrier device that covers a victim’s A barrier device that covers a victim’s mouthmouth

Face mask-Face mask- A barrier device that covers a victim’s A barrier device that covers a victim’s mouth and nosemouth and nose

InadequateInadequate breathing- breathing- Breathing that is too slow Breathing that is too slow or shallow to support lifeor shallow to support life

Stoma-Stoma- A surgical opening in the neck A surgical opening in the neck

1212

To help prevent gastric To help prevent gastric distention:distention:

Blow only hard enough to make the chest Blow only hard enough to make the chest rise.rise.

Deliver steady breaths over one second Deliver steady breaths over one second with a volume of air that makes the chest with a volume of air that makes the chest rise. rise.

Make sure the airway is open.Make sure the airway is open.

1313

PROGRESS CHECKPROGRESS CHECK

1. The most effective form of artificial ventilation is ____________.1. The most effective form of artificial ventilation is ____________.(mouth-to-mouth/mouth-to-barrier/mouth-to-nose)(mouth-to-mouth/mouth-to-barrier/mouth-to-nose)2. Deliver two full, slow rescue breaths, each one lasting about 2. Deliver two full, slow rescue breaths, each one lasting about

____________ seconds. ____________ seconds. (2/3/4)(2/3/4)3. Perform rescue breathing at the rate of about ____________ 3. Perform rescue breathing at the rate of about ____________

breaths per minute. breaths per minute. (10/12/14)(10/12/14)4. The most common cause of ventilation difficulty is 4. The most common cause of ventilation difficulty is

____________.____________.(insufficient air/obstructed airway/improper positioning of the (insufficient air/obstructed airway/improper positioning of the

head andhead andchin)chin)5. Decompress gastric distention only if you cannot ____________ 5. Decompress gastric distention only if you cannot ____________

because of the inflated stomach. because of the inflated stomach. (see the chest rise and (see the chest rise and fall/ventilate the victim)fall/ventilate the victim)

6. If the victim is an infant or child, ventilations should be faster 6. If the victim is an infant or child, ventilations should be faster and more ____________. and more ____________. (shallow/forceful)(shallow/forceful)

1414

Monitor the victim carefully, Monitor the victim carefully, watching for the following signs of watching for the following signs of

reduced air passage:reduced air passage:

A weak, ineffective coughA weak, ineffective cough A high-pitched wheeze during inhalationA high-pitched wheeze during inhalation Increased strain during breathingIncreased strain during breathing Clutching at the throatClutching at the throat Slight cyanosisSlight cyanosis

1515

Signs of complete airway Signs of complete airway obstruction areobstruction are

Inability to speak, groan, cough, or cry out Inability to speak, groan, cough, or cry out (the victim of a heart attack or other (the victim of a heart attack or other emergency will be able to at least whisper)emergency will be able to at least whisper)

Absence of breath soundsAbsence of breath sounds Labored use of muscles required in Labored use of muscles required in

breathing— flared nostrils, strained neck breathing— flared nostrils, strained neck and facial musclesand facial muscles

Progressive restlessness, anxiety, and Progressive restlessness, anxiety, and

confusionconfusion UnresponsivenessUnresponsiveness

1616

VocabularyVocabulary

Gastric distention-Gastric distention- Inflation of the Inflation of the stomach with air stomach with air

Aspiration-Aspiration- Breathing foreign Breathing foreign matter into the lungsmatter into the lungs

1717

1818

If the Victim Is Obese or PregnantIf the Victim Is Obese or Pregnant

1.1. Stand behind the victim - wrap your armsStand behind the victim - wrap your arms

around the victim’s chestaround the victim’s chest

2. Position the thumb side of your fist on the middle2. Position the thumb side of your fist on the middle

of the breastboneof the breastbone

3. Seize your fist firmly with your other hand, and3. Seize your fist firmly with your other hand, and

thrust backward sharply. Repeat thrust backward sharply. Repeat

4. If the victim is or becomes unconscious, place the4. If the victim is or becomes unconscious, place the

victim on his or her back -give distinct, separate victim on his or her back -give distinct, separate thrusts downward and toward the headthrusts downward and toward the head

1919

PROGRESS CHECKPROGRESS CHECK

1. The most reliable sign of complete airway obstruction is 1. The most reliable sign of complete airway obstruction is ___________.___________.

(cyanosis/a snoring sound during breathing/complete inability to (cyanosis/a snoring sound during breathing/complete inability to speak)speak)

2. The Heimlich maneuver is an abdominal thrust delivered just 2. The Heimlich maneuver is an abdominal thrust delivered just below the ____________. below the ____________. (sternum/diaphragm/rib cage)(sternum/diaphragm/rib cage)

3. During the Heimlich maneuver, your thumb should be 3. During the Heimlich maneuver, your thumb should be positioned slightly above the ____________. positioned slightly above the ____________. (xiphoid (xiphoid process/diaphragm/navel)process/diaphragm/navel)

4. If the victim with an obstructed airway is unconscious, the 4. If the victim with an obstructed airway is unconscious, the victim should be positioned on the ____________. victim should be positioned on the ____________. (back/side/stomach)(back/side/stomach)

5. If the victim with an obstructed airway is a conscious infant, 5. If the victim with an obstructed airway is a conscious infant, you should first do ____________. you should first do ____________. (back blows/chest thrusts/a (back blows/chest thrusts/a finger sweep)finger sweep)

6. If the victim with an obstructed airway is an unconscious 6. If the victim with an obstructed airway is an unconscious infant, you should first do ____________. infant, you should first do ____________. (back blows/chest (back blows/chest thrusts/a finger sweep)thrusts/a finger sweep)

2020

Key TermsKey Terms

respiratory distressrespiratory distress respiratory arrestrespiratory arrest inadequate inadequate

breathingbreathing stomastoma

face shieldface shield face maskface mask gastric distentiongastric distention aspirationaspiration