(b) If the casualty has a temporary tracheostomy tube in the trachea,
the tube may have a cuff that can be inflated to seal off the airway above the stoma and
thus prevent air from escaping through the mouth or nose.
(3) Seal the stoma. Place your mouth over the casualty's stoma. Make
sure that your mouth forms an airtight seal so that air will not escape when you blow air
into the stoma.
(4) Deliver the first breath. Blow a breath into the stoma. His chest should
rise as his lungs fill with air.
(5) Take another breath. After delivering the first breath, quickly break the
seal over the stoma, take a breath of air, exhale, and then take another breath. His
chest should fall somewhat as air escapes from the stoma after you break the seal.
You may be able to hear or feel the exhaled air also.
Seal the stoma. Seal your mouth over the stoma again so that air will
(7) Deliver the second breath. Blow another breath at a slow rate into the
stoma and observe the casualty's chest.
(8) Break seal. After delivering the second breath, break the seal over the
stoma. If you are holding the casualty's mouth and nose closed, you can release them.
The casualty's body will exhale naturally.
3-10. EVALUATE THE EFFECTIVENESS OF THE TWO VENTILATIONS
a. Spontaneous Breathing Resumes. If the casualty begins breathing again
on his own, check his circulation and continue your assessment. Do not leave the
casualty since his breathing may stop again. The casualty may still require help to keep
his airway open.
b. Airway Blocked. If the casualty's chest did not rise and fall, then fresh air is
not getting into his lungs. Reposition the casualty's airway in an attempt to open the
airway. Then administer two breaths again using the same procedures. If the
casualty's chest still does not rise, he probably has an object blocking his airway.
Remove the obstruction using finger sweeps and manual thrusts as described in
paragraph 5-6. Once the obstruction has been removed, administer two full breaths
and proceed to check the casualty's pulse (paragraph 3-11).
c. Airway Open with No Spontaneous Breathing. If air goes in and out of the
casualty's lungs (airway open) but he does not start breathing on his own, check his
pulse (paragraph 3-11) and determine if chest compressions are required.