appears bloated. This condition is called gastric
distention. If gastric distention develops, open the
airway even more and cut down on the amount of air
you are providing, BUT DO NOT attempt to expel the
stomach contents by pushing on the abdomen. If the
patient vomits while you are giving mouth-to-mouth
ventilation, turn his head to one side and clear the
airway.
CIRCULATION
Cardiac arrest occurs when the heart stops
functioning. If the victim is to live, take action
immediately to restore the victim's heart function. The
Figure 10-9.--Feeling for the carotid pulse.
signs of cardiac arrest include the absence of a pulse,
because the heart is not beating, and the absence of
breathing.
Mouth-to-Mouth Ventilation
A rescuer who knows how to administer CPR
increases the chances of a victim's survival. CPR
To perform mouth-to-mouth ventilation, place one
consists of artificial ventilation and external heart
hand under the victim's neck; place the heel of the other
compressions. The lungs are ventilated by using the
hand on his forehead; use the thumb and index finger to
mouth-to-mouth or mouth-to-nose technique; the
pinch his nostrils shut. Tilt his head back to open the
compressions are performed by pressing the chest with
airway. Take a deep breath, cover the victim's mouth
the heels of your hands. The victim should be laying
with your own, and blow into the victim's mouth.
faceup on a firm surface.
Briefly remove your mouth from the victim's mouth to
CPR should not be attempted by a rescuer who has
allow exhalation. Initially, give four quick breaths in
not been properly trained, as mentioned earlier in this
succession, allowing the lungs to deflate, only partially.
chapter. To learn this technique, contact your medical
Observe the victim's chest for movement. Check the
education department.
victim's neck pulse (carotid artery), as shown in figure
The rescuer must not assume that cardiac arrest has
10-9. When a pulse is present, continue rescue breathing
occurred solely because the victim is lying on the deck
at the rate of 12 ventilations per minute (one breath every
and appears to be unconscious (fig. 10-10). First, try to
5 seconds).
arouse the victim by gently shaking his shoulders and
by trying to obtain a response; loudly ask, "Are you
Mouth-to-Nose Ventilation
OK?" Be careful if the victim shows signs of head and
spinal injuries. If there is no response, place the victim
Mouth-to-nose ventilation is effective when the
faceup on a firm surface. Kneel at a right angle to the
victim has extensive facial or dental injuries; this
victim, and open the airway, using the head tilt-neck lift,
permits an effective air seal.
the head tilt-chin lift, or the jaw thrust methods
To administer this method, seal the victim's mouth
previously discussed. Look for chest movement. Listen
with your hand, take a deep breath, and place your lips
and feel for air coming from his nose or mouth for at
over the victim's nose and blow. To assist the victim to
least 5 seconds. If the pulse is absent, call for help and
exhale, you may open the lips. Start artificial ventilation
begin CPR.
with four quick breaths in succession, allowing the lungs
Locate the lower margin of the victim's rib cage on
to deflate, only partially. Check the victim's neck pulse.
the side closest to you by using your middle and index
If a pulse is present, continue rescue breathing at the rate
fingers. Then move your fingers up along the edge of
of 12 ventilations per minute (one breath every 5
his rib cage to the notch (xiphoid process) where the ribs
seconds).
meet the sternum in the center of his lower chest. Your
Gastric Distention
middle finger should be placed on the notch with your
index finger next to it. The heel of your other hand
Sometimes during artificial ventilation, air enters
should be placed along the midline of his sternum, next
the stomach instead of the lungs. and the abdomen
to your index finger. You must keep the heel of your hand
10-6