(2) Open the airway and perform artificial respiration (rescue breathing), if
necessary. If your check shows that the casualty is not breathing, begin artificial
respiration. There are three methods of rescue breathing: mouth-to-mouth, mouth-to-
nose, and mouth-to-stoma. The most commonly used method is mouth-to-mouth.
Mouth-to-nose is used when the casualty's mouth can't be opened or when the rescuer
can't achieve a tight seal around the casualty's mouth. Mouth-to-stoma is used when
there is an opening in the casualty's neck for breathing. Remember that mouth-to-
mouth rescue breathing requires a good airseal of your mouth and the casualty's mouth
in order to inflate the lungs. Here is the procedure for mouth-to- mouth rescue
breathing. If you need more information, refer to Subcourse MD0571, Cardiac
Impairment, and look at Lesson 3(Basic Cardiac Life Support).
(a) Pinch the casualty's nostrils shut.
(b) Open your mouth wide and take a deep breath.
Place your mouth tightly over the patient's mouth. Make an airtight
(d) Blow your breath into the casualty's mouth. You should see the
casualty's chest rise as air fills his lungs. You should feel and hear the air as it is
exhaled from the casualty's lungs.
(e) Remove your mouth and allow the casualty to exhale.
(f) Initially, repeat steps two through five four times. Do not wait for
the lungs to deflate fully.
Maintain a rate of 16 to 20 respirations per minutes.
Check for a carotid pulse and perform cardiopulmonary resuscitation
(a) Carotid pulse. Palpate the carotid artery for a pulse rather than
trying to find a radial pulse at the wrist or a temporal pulse. The carotid arteries carry
blood to the brain and the head, and a pulse can usually be felt here when other pulses
have disappeared. The carotid arteries are located on each side of the neck. The pulse
can be most easily felt next to the larynx (the voice box). Follow these steps to locate
the carotid pulse:
1 Locate the larynx. The larynx is also called the "Adam's apple"
or voice box. It is located in the front center of the neck.
2 Use the tips of your index and middle fingers.