To perform mouth-to-mouth ventilation, place one hand under the victim's neck; place the heel of the other hand on his forehead; use the thumb and index finger to pinch his nostrils shut. Tilt his head back to open the airway. Take a deep breath, cover the victim's mouth with your own, and blow into the victim's mouth. Briefly remove your mouth from the victim's mouth to allow exhalation. Initially, give four quick breaths in succession, allowing the lungs to deflate, only partially. Observe the victim's chest for movement. Check the victim's neck pulse (carotid artery), as shown in figure 10-9. When a pulse is present, continue rescue breathing at the rate of 12 ventilations per minute (one breath every 5 seconds).

Mouth-to-Nose Ventilation

Mouth-to-nose ventilation is effective when the victim has extensive facial or dental injuries; this permits an effective air seal.

To administer this method, seal the victim's mouth with your hand, take a deep breath, and place your lips over the victim's nose and blow. To assist the victim to exhale, you may open the lips. Start artificial ventilation with four quick breaths in succession, allowing the lungs to deflate, only partially. Check the victim's neck pulse. If a pulse is present, continue rescue breathing at the rate of 12 ventilations per minute (one breath every 5 seconds).

Gastric Distention

Sometimes during artificial ventilation, air enters the stomach instead of the lungs. and the abdomen appears bloated. This condition is called gastric distention. If gastric distention develops, open the airway even more and cut down on the amount of air you are providing, BUT DO NOT attempt to expel the stomach contents by pushing on the abdomen. If the patient vomits while you are giving mouth-to-mouth ventilation, turn his head to one side and clear the airway.