First Responder EMS Curriculum for Training Centers in Eurasia

4. Place your other fingers along the bony margin of the jaw and lift the jaw whileperforming a head tilt.5. Give one slow (1 ½ - 2 second) breath of sufficient volume to make the chest rise(usually 800 to 1,200 ml in the average adult).6. Too great a volume of air and too fast an inspiratory time are likely to allow air toenter the stomach.7. Adequate ventilation is determined by:• Observing the chest rise and fall• Hearing and feeling the air escape during exhalation8. Continue at the proper rate.• 10 to 12 breaths per minute for adults with 1 ½ - 2 second ventilation time• 20 breaths per minute for children and infants with 1-12 second inspiratory time• 40 breaths per minute for newborns with 1-12 second inspiratory time9. If the ventilation cannot be delivered, consider the possibility of an airwayobstruction.b. Mouth-to-Barrier DeviceA barrier device should be used if available when no ventilation mask is available.Some rescuers may prefer to use a barrier device during ventilation; however, barrierdevices have no exhalation valve and air often leaks around the shield. Barrier devicesshould have low resistance to delivered ventilation.Technique1. If ventilation is necessary, position the device over the patient's mouth and nose,ensuring an adequate seal.2. Keep the airway open by the head tilt-chin lift or jaw-thrust maneuver.3. Give one slow (1 ½ - 2 second) breath of sufficient volume to make the chest rise(usually 800 to –1,200 ml in the average adult).4. Too great a volume of air and too fast an inspiratory time are likely to allow air toenter the stomach.5. Adequate ventilation is determined by:• Observing the chest rise and fall• Hearing and feeling the air escape during exhalation6. Continue at the proper rate.• 10 to 12 breaths per minute for adults, with 1 ½ - 2 second inspiratory time• 20 breaths per minute for children and infants, with 1-12 second inspiratory time• 40 breaths per minute for newborns, with 1-12 second inspiratory time7. If the ventilation cannot be delivered, consider the possibility of an airwayobstruction.c. Mouth to MouthThe First Responder must be aware of the risks of performing mouth-to-mouthventilation. The risks include exposure to potentially infectious bodily fluids such asblood, which may carry infectious diseases including hepatitis or humanimmunodeficiency virus. However, mouth-to-mouth is a quick, effective method ofdelivering oxygen to the non-breathing patient. This method involves ventilating apatient with your exhaled breath while making mouth-to-mouth contact. The rescuer'sexhaled air contains enough oxygen to support life. Barrier devices and face masks with68First Responder EMS Curriculum/AIHA, July 2002