Mouth to Mouth Resuscitation

Table of Contents:

1. What Is Mouth To Mouth Resuscitation?
2. When does a person require Mouth To Mouth Resuscitation?
3. How To Give Mouth To Mouth?
4. Mouth-To-Mouth Resuscitation Steps
5. Precautions during Mouth To Mouth Resuscitation

 

Troubled breathing or a stoppage in breathing is an alarming situation. It often creates panic not only for the victim or patient but also for those around them. Troubled breathing may occur from any underlying disease, an accident, etc. Therefore, carrying out a timely first aid activity is necessary to help the individual sustain the situation and survive it. Roughly 40% of out-of-hospital cardiac arrest (OHCA) survivors receive CPR immediately from a witness, which increases the survival chances quite significantly.

In the case of halted and troubled breathing, mouth-to-mouth resuscitation is the easiest and fastest-adaptable approach when no other help is available to restore breathing. In this blog, we will discuss various aspects of mouth-to-mouth resuscitation and every necessary detail to remember in an alarming situation. 

 

What Is Mouth-To-Mouth Resuscitation?

Mouth-to-mouth resuscitation is a method of providing artificial ventilation to a patient in need of emergency attention, usually outside a hospital. It is usually performed on patients who have trouble breathing or have stopped breathing. 

The person who provides this kind of resuscitation or help is often referred to as a rescuer. In this method of providing ventilation to an individual in need of assistance in breathing, the rescuer places their mouth against the mouth of the patient and blows out a very large amount of air into the patient’s lungs. This stimulates the patient’s breathing, which results in the restoration of their internal respiration.

 

When Does A Person Require Mouth-to-Mouth Resuscitation?

Mouth-to-mouth respirations are usually performed along with most Cardiopulmonary resuscitations (CPR) as a protocol for saving the life of those under cardiac arrest or similar critical event. However, there are certain cases where mouth to mouth breathing may be provided without giving chest compression, similar to that done in CPR.

Below is a list of a few conditions in which mouth-to-mouth resuscitation, along with chest compression, as in CPR, is necessary to restore an individual’s breathing.

• Choking due to airway blockage,
• Drowning or Near drowning,
• Respiratory arrest with cardiac arrest,
• Severe Asthma Attack or Anaphylaxis,
• Suffocation due to smoke inhalation,
• Somebody who has been accidentally electrocuted, 
• A person’s drug overdose can significantly slow down normal breathing.

However, there are cases when only mouth to mouth resuscitation without chest compression is required to be performed to restore the breathing of an individual in need. This includes conditions like respiratory arrest without cardiac arrest or failure of heart activity.

Read More: Head-Tilt/Chin-Lift Maneuver: How to Open an Obstructed Airway

 

How To Do Mouth To Mouth Resuscitation?

Mouth-to-mouth resuscitation is achieved by the help of a rescuer forcing air into the lungs of the patient. The rescuer closely seals their mouth onto that of the patient. Then, the rescuer blows out a large volume of air into the patient’s lungs to help the patient initiate breathing. 

• Mechanically forcing air into the patient’s respiratory pathway during this procedure is a form of providing ventilation and is often referred to as insufflation. 
• During mouth-to-mouth resuscitation alone, the rescuer must give at least 1 rescue breath every 5 to 6 seconds or 10-12 rescue breaths every minute.
• If mouth-to-mouth resuscitation is provided as a part of CPR, ensure a ratio of 30-2-30 referring to 30 chest compressions followed by 2 rescue breaths and, after that again, 30 chest compressions. 
• Make sure that there doesn’t happen to occur any time gap between the chest compressions and rescue breaths during mouth to mouth CPR.

 

Mouth-To-Mouth Resuscitation Steps

Mouth to mouth resuscitation procedure has certain specific steps on how it should be performed. Performing each mouth to mouth resuscitation step correctly is crucial to ensure a positive outcome.  Below listed are the main steps on how to give mouth to mouth resuscitation:

• Lie down the patient straight on their back and gently tilt the patient’s head backwards. 
• Ensure that no object is blocking the mouth or airway. If you notice one, gently remove it with your fingers.
• Once a clear airway is established, using one of your hands, gently tilt the patient’s chin. Keep the patient’s mouth open with the help of the thumb of the same hand.
• The rescuer should place the other hand over the patient’s forehead and tightly pinch the patient’s nose using the thumb and index finger.
• The rescuer should now inhale a normal breath. Then, the rescuer should place their mouth over that of the patient’s and blow out the air into the patient’s lungs.
• This blow should result in a visible expansion or rise of the chest, which also lowers or sinks when the rescuer moves.
• Repeat the blowing multiple times, based on the main purpose, if the resuscitation is assisted by CPR chest compressions or alone.

A similar variant of providing artificial ventilation mouth to nose resuscitation. In this method, the rescuer seals their mouth around the patient’s nose and blows strongly enough into it to provide airflow into the patient’s respiratory pathway. This method is performed when blowing into the patient’s mouth is not possible due to facial trauma or injury in or near the mouth.

Read More: Recognizing and Treating Paradoxical Breathing

 

Precautions During Mouth To Mouth Resuscitation

Although mouth-to-mouth resuscitation is an emergency protocol, certain precautions need to be considered. This can help ensure that the resuscitation efforts will not go in vain or pose any risk to the rescuer. Make sure to note the below things when carrying out a mouth-to-mouth resuscitation.

• Ensure that the person does not fall under the DNR category or Do Not Resuscitate category.
• If any supposedly large object is blocking the airway or if you are unable to remove that object with your fingers, apply the Heimlich manoeuvre to remove that foreign object.
• Ensure that there is no thigh clothing over the patient.
• Clear any crowds, if any, present surrounding the patient.
• Avoid delivering overly large volumes of breath to avoid overinflating the victim’s lungs.
• Remove the mask if the patient was wearing any.
• If the patient is suspected to have any spinal injury, avoid correcting their lying position until paramedical aid or first aid arrives.
• Ensure to rotate the patient every 2 minutes while giving the compression over the chest.
• The rescuer should wear a pocket mask to avoid cross-infection. 
• The mask worn by the rescuer has a one-way filter that allows the flow of air in a single direction—from the rescuer to the patient.

 

Final Thoughts 

A person must know the proper rules, steps and precautions of mouth to mouth resuscitation to carry it out effectively. Only individuals trained under proper guidelines can perform it to give a positive outcome. A rescuer must be trained properly to perform mouth-to-mouth resuscitation efficiently.

Proper mouth-to-mouth resuscitation during CPR helps sustain the patient’s breath until an AED is brought to the site of the event. An individual with proper knowledge of CPR mouth-to-mouth resuscitation can not only promise a better survival rate but also lower long-term complications. It also provides support during post-cardiac arrest care and plays a key role during cardiopulmonary resuscitation.