Breathing difficulties

Respiration is one of the most important vital functions for human beings. During respiration, oxygen combines with the circulation to provide all the tissues in the body with the fuel necessary to produce energy. Breathing is so vital that someone who has stopped breathing needs first aid fast. Unless oxygenated blood reaches the brain within four to six minutes, a casualty may suffer permanent brain damage or die. There are three basic reasons why a person may have stopped breathing: first, the airway may be obstructed; second, the brain may have stopped sending the appropriate signals to the muscles that are used in breathing; third, the chest may be injured. In the first case, the airway may be blocked by blood, vomit or false teeth, or possibly the casualty has choked while eating food; if the casualty is unconscious, the tongue may have fallen to the back of the throat, thus cutting off the airway. In the second case, breathing may have stopped because the casualty has suffered a brain injury or because he or she has been electrocuted, poisoned, gassed or partially drowned. Always remember to check that you are not putting yourself in danger by going to his or her aid. In the third case there may have been crushing caused by a chest injury, or an air leak through the chest wall that has given rise to pneumothorax.

Most important thing is that air is able to get into the lungs. For this reason the head of the casualty should be bent backwards at the neck. Only then is the tongue prevented from closing the airway at the back of the mouth.v

With mouth-to-mouth resuscitation, keep the casualty’s nose sealed by pinching the nostrils; with mouth-to-nose, hold the jaws closed and seal the lips with your fingers or thumb. If you find the idea of such intimate contact with someone who may be severely wounded but who is also a stranger distasteful, artificial respiration can be performed through a clean handkerchief or nylon tights. The first four breaths should be given as quickly as possible, without waiting for the casualty’s chest to fall. Breaths should then be given about 18 times a minute (one every three to four seconds), waiting for the chest to fall after each one.

External chest compression

It makes no sense ventilating the casualty’s lungs if his or her heart is not beating to move the oxygenated blood around the body. After the first four breaths, check for a pulse in the neck. If this is absent, external chest compression should be performed, in preference by someone who is properly trained in the technique.

Is the casualty breathing?

If you are in doubt about the presence of breathing, place the casualty on his or her back and kneel at the head so that you can hear and, especially if there is a lot of background noise, feel his or her breaths, at the same time as observing whether the chest is rising and falling. Although it is dangerous to perform external chest compression to assist the heart if there is even a faint heartbeat, artificial respiration is necessary not only if someone has stopped breathing but also if breathing is weak or failing. If the casualty has stopped breathing altogether, first position the casualty on his or her back with the jaw held forward to draw the tongue away from the back of the throat. You may need to remove from the casualty’s mouth any vomit, food, false teeth or loose natural teeth that may be blocking the airway: turn the head to one side and quickly check inside the mouth with a couple of your fingers. In many cases, these measures are enough to get someone breathing again, in which case you should move them into the recovery position. If not, proceed to give them artificial respiration.

Artificial respiration

Artificial respiration can be given mouth-to-mouth, mouth-to-nose or, in the case of small children, mouth-to-mouth-and-nose. Mouth-to-mouth has the advantage that you can watch the casualty’s chest rise and fall, but it should not be used if you suspect poisoning by mouth. Whatever method is chosen, the