(6) Take another breath. After blowing into the casualty's nose, quickly
break the seal over his nose, take a breath of air, exhale, and take another deep breath.
His chest should fall somewhat as air escapes from the casualty's nose after you break
the seal. You may be able to hear or feel the exhaled breath also.
(7) Seal the nose. Seal your mouth over the casualty's nose again so that
air will not escape.
(8) Deliver the second breath. Blow another breath into the casualty's nose
at a slow rate and observe the casualty's chest.
(9) Break the seal and open mouth. After delivering the second breath,
break the seal over the casualty's nose and allow his mouth to open slightly while
continuing to maintain the open airway. (The mouth is opened in case there is an
obstruction in the casualty's nasal passages.) The casualty's body will exhale naturally
without effort on your part. If the mouth does not open readily, use your thumb to
depress the lower lips slightly to separate the lips.
c. Mouth-to-Stoma. The mouth to stoma rescue breathing is used if a
permanent or temporary opening has been made at the front base of the neck in order
to open the airway to the atmosphere.
Inhale. Take a breath.
(2) Close the mouth and nose, if needed. Use a hand to close the
casualty's mouth and nostrils in order to prevent air escaping.
(a) This step is not needed if the casualty's upper airway has been
closed surgically, as shown in figure 3-8.
Figure 3-8. Administering mouth-to-stoma rescue breathing.