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‡artificial respiration, any measure that
causes air to flow in and out of a
person's lungs when natural breathing
is inadequate or ceases, as in
respiratory paralysis, drowning,
electric shock, choking, gas or smoke
inhalation, or poisoning
 ||


‡Mouth to mouth
‡Mouth to nose
‡Mouth to mouth and nose
‡Mouth to mask
-Bag valve mask
‡Silvester method
‡Holger Nielsen
p




 Èin maxillofacial
injuries, performing the procedure in
water or the remains of vomit in the
mouth







|
 -
Used on infants (usually up to around
1 year old), as this forms the most
effective seal
p



| È to reduce cross
infection risk. One popular type is the
'pocket mask'. This may be able to
provide higher tidal volumes than a
Bag Valve
‡ In Drowning do not waste time trying
to "empty water out of the lungs" by
jackknifing or rolling on a barrel.
‡bag valve mask When the air chamber or
"bag" is squeezed, the device forces air
through into the patient's lungs; when the
bag is released, it self-inflates, drawing in
ambient air or a
low pressure oxygen flow supplied
from a regulated cylinder, whilst the
patient's lungs deflate to the air through
the one way valve
The Silvester Method of artificial respiration
in which the patient is laid on their back, and
their arms are raised above their head to aid
inhalation and then pressed against their chest
to aid exhalation.The procedure is repeated
sixteen times per minute
Holger nieslen method:
 ||


‡ Drinker and Shaw tank
‡ Mechanical ventilator
-Transport ventilators
-ICU ventilators
-High Frequency ventilator
-Tracheal intubation
-Oesophageal obturator airway
-Cricothyrotomy
-Tracheostomy
Drinker·s method
-iron lung chamber
In the iron lung by means of a pump, the air is
withdrawn mechanically to produce a vacuum inside
the tank, thus creating negative pressure. This
negative pressure leads to expansion of the chest,
which causes a decrease in intrapulmonary pressure
and flow of ambient air into the lungs. As the
vacuum is released, the pressure inside the tank
equalizes to that of the ambient pressure, and the
elastic coil of the chest and lungs leads to passive
exhalation.
‡Positive pressure machines
‡Positive-pressure ventilators work by
increasing the patient's airway
pressure through an endotracheal or
tracheostomy tube or tracheoHand-
controlled ventilation
 High frequency ventilator
High frequency ventilation is a type of mechanical
ventilation that employs very high respiratory rates
(>150 breaths per minute) and very small tidal volumes
(usually below anatomical dead space)
‡ NICU ventilators--Designed with the preterm
neonate in mind

‡ PAP ventilators-- these ventilators are

specifically designed for non-invasive
ventilation. this includes ventilators for use at
home, in order to treat sleep apneaá
‡ Tracheotomy and tracheostomy are surgical
procedures on the neck to open a direct airway
through an incision in the trachea (the
windpipe
‡Tracheal intubationA tube is inserted
through the nose (nasotracheal intubation)
or mouth (orotracheal intubation) and
advanced into the trachea
‡Cricothyrotomy where an airway is
inserted through a
surgical opening in
the cricothyroid membrane
R



 
‡Cardiopulmonary resuscitation (CPR)
is an emergency medical procedure for a
victim of cardiac arrest or, in some
circumstances, respiratory arrest
‡CPR consists of artificial blood
circulation and artificial respiration
(i.e. chest compressions and lung
ventilation).
‡CPR is unlikely to restart the heart, but
rather its purpose is to maintain a flow of
oxygenated blood to the brain and the
heart, thereby delaying tissue death and
extending the brief window of opportunity
for a successful resuscitation without
permanent brain damage.
‡Defibrillation and advanced life support
are usually needed to restart the heartá
‡The best estimate of the heart efficiency
during CPR is 20-30% of normal.
‡You are breathing oxygen into the lungs.
Your exhaled breath contains 16% oxygen
which is close to the 20% contained in the
air you breathe in, while the carbon-di-
oxide stimulate the respiratory center
‡ A universal compression-ventilation ratio (30:2)
recommended for all single rescuers of
-infant ,child and adult victims (excluding
newborns).
Ratio for the two person CPR is 5 :1, at a rate
of 80 compressions per minute

‡ The primary difference between the age groups is that

with adults the rescuer uses two hands for the chest
compressions,
‡ while with children it is only one, and
‡ with infants only two fingers (index and middle
fingers).
‡ CPR is only likely to be effective if
commenced within 6 minutes after the blood
flow stops,
because permanent brain cell damage
occurs when fresh blood infuses the cells
after that time, since the cells of the brain
become dormant in as little as 4-6 minutes
in an oxygen deprived environment and the
cells are unable to survive the reintroduction
of oxygen in a traditional resuscitation
á

‡Remember the ABCs

Think ABC - Airway,

- Breathing and
-Circulation

.
‡ AIRWAY: Clear the airway
‡ Put the person on his or her back on a firm surface.
‡ Kneel next to the person's neck and shoulders.
‡ Open the person's airway using the head-tilt, chin-lift
maneuver. Put your palm on the person's forehead and gently
tilt the head back. Then with the other hand, gently lift the
chin forward to open the airway.
‡ Check for normal breathing, taking no more than five or 10
seconds: Look for chest motion, listen for breath sounds, and
feel for the person's breath on your cheek and ear. Gasping is
not considered to be normal breathing. If the person isn't
breathing normally and you are trained in CPR, begin mouth-
to-mouth breathing. If you believe the person is unconscious
from a heart attack and you haven't been trained in
emergency procedures, skip mouth-to-mouth rescue breathing
and proceed directly to chest compression
 BREATHING:
‡ With the airway open (using the head-tilt, chin-lift
maneuver) pinch the nostrils shut for mouth-to-mouth
breathing and cover the person's mouth with yours,
making a seal.

‡ Prepare to give two rescue breaths. Give the first

rescue breath ³ lasting one second ³ and watch to
see if the chest rises. If it does rise, give the second
breath. If the chest doesn't rise, repeat the head-tilt,
chin-lift maneuver and then give the second breath.
CIRCULATION: Restore blood circulation with chest
compressions
‡ Place the heel of one hand over the center of the person's
chest, between the nipples.
Place your other hand on top of the first hand. Keep your
elbows straight and position your shoulders directly above
your hands.
‡ Use your upper body weight (not just your arms) as you push
straight down on (compress) the chest 2 inches (approximately
5 centimeters). Push hard and push fast ³ give two
compressions per second, or about 100 compressions per
minute.
‡ After 30 compressions, tilt the head back and lift the chin up
to open the airway. Prepare to give two rescue breaths. Pinch
the nose shut and breathe into the mouth for one second.
‡Timing devices--They can feature a
metronome (an item carried by many
ambulance crews) in order to assist the
rescuer in getting the correct O
á
‡Manual Assist deviceÈ CPREzy
‡Automatic device-LUCAS
 Rhythmic Abdominal Compressions
‡Rhythmic abdominal compression-CPR
works by forcing blood from the blood
vessels around the abdominal organs,
an area known to
contain about 25 percent of the body's
total blood volume. This blood is then
redirected to other sites, including the
circulation around the heart.
‡Frequently ribs are broken with the
pressure CPR places on the sternum.
Some studies quote up to 30% of
cardiac arrest victims have broken ribs
as a result of CPR.
But remember, it's better to have a
cracked rib than be dead.
‡Can I kill someone if I do CPR
incorrectly?
‡No. Remember the person in cardiac
arrest is already clinically dead. CPR
can only help. Even if it's not done
"letter perfect" it will probably provide
some benefit to the victim.
‡When should I stop CPR?
When help arrives to take over, or
the victim starts to move.
CCR (Cardiocerebral Resuscitation)
is simply chest compressions without
artificial respiration is the key to
helping someone recover from cardiac
arrest.
‡CPR can double or triple the victim's
chances of survival when commenced
immediately
‡On average, only 5%-10% of people
who receive CPR surviveá
‡There has never been a case of HIV
transmitted by mouth-to-mouth CPR
‡If the victim is obviously pregnant or
known to be pregnant, adjust your
hand position to be slightly higher on
the chest
-THANK
YOU