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Now let's cover rescue breathing for the healthcare professional on an adult patient. Now in this case, we still need to make sure the scene is safe and that our gloves are on, but when we assess the patient, our main point here is can we find a pulse or not? And if we can't find one, we're going to be going onto CPR. But if we do find a pulse and we're confident that it's a pulse then we're going to be doing rescue breathing and this is how it's going to look. My scene is safe. My gloves are on. My rescue mask with a one-way valve is available. Sir, are you all right? Are you okay? They don't respond. I tap and shout. Sir, can you hear me? They still don't respond. I activate EMS or I call a code. You in the plaid shirt, go call 911 and come back. I might need your help and if you can find an AED, please bring it with you. Now I'm going to head tilt, chin lift, look for normal breathing and check for a pulse for no more than ten seconds. Immediately I can feel a pulse, but the patient is not breathing normally. This includes the potential for agonal respirations which we've covered in other trainings. But it's not considered real breathing. So this person is going to receive now one breath every six seconds for a total of about two minutes before I reassess the pulse. And it looks like this. One one thousand, two one thousand, three one thousand, four one thousand, five one thousand. One one thousand, two one thousand, three one thousand, four one thousand, five one thousand. So I continue giving these rescue breaths, one breath every five seconds and in about two minutes, I recheck for a carotid pulse. If the pulse is present but the patient is not breathing, I continue rescue breathing and I await EMS and I have the AED here, ready to go in case I lose the pulse as well. If at any time on my reassessment the breathing is not there and there is no carotid pulse, I'm going to go immediately into CPR. If my AED is present I'm going to use the AED right away and I'll go into CPR mode. And we'll continue this rescue breathing until help arrives or the patient revives.
In this lesson, we're going to look at how and when to use rescue breathing on an unconscious adult patient.
The main factor when it comes to rescue breathing is whether or not you can find a pulse. As you know, if the patient isn't breathing normally and doesn't have a pulse, you go immediately into CPR.
However, if when assessing the patient, you do find a pulse and are confident that it is a pulse, that's when you'll use rescue breathing.
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
Pro Tip #1: You're going to continue to perform one rescue breath every six seconds for two minutes. At that time, reassess the patient. If you still detect a pulse but the patient isn't breathing normally, continue with one rescue breath every six seconds for two more minutes. And so on.
Pro Tip #2: Make sure the patient's chest rises as you perform your rescue breaths. If it doesn't, this could indicate an airway obstruction.
Warning: If at any point you discover that the patient's pulse is gone, go immediately into full CPR and use an AED if you have one available.
The respiratory system is divided into two parts – the upper airway tracts and the lower airway tracts.
The lower airway tracts access the respiratory system through the nose and mouth. As air is inhaled through the nose, it's warmed and humidified. Air inhaled through the mouth goes over the tongue and into the pharynx.
The pharynx is divided into three parts – the nasopharynx, the oropharynx, and the laryngopharynx. The nasopharynx lies behind the nasal cavity. The oropharynx is located behind the oral cavity and is the shared passageway for both food and air.
The laryngopharynx is the lowest part of the throat and divides into two passageways. The back portion is the entrance to the esophagus, which is the passageway for food. The front portion is the larynx, which is the continuation of the respiratory system.
Above the larynx is the epiglottis – a flap of cartilage that folds down over the larynx to close it off to the trachea during swallowing, so that food doesn't enter. Incidentally, this only works if the person is conscious.
After air travels through the pharynx, it then passes through the larynx. At the top of this structure is the hyoid bone (a horseshoe-shaped bone that helps support the structure of the larynx), made mostly of cartilage, muscle, and membranes. Below the hyoid bone are the thyroid and cricoid cartilages, which form the larynx.
The lower airway tract begins below the vocal cords and consists of the trachea, bronchi, and lungs. The trachea is a hollow tube that's supported by rings of cartilage. It extends downward until it divides into two branches called bronchi, that connect with each lung. The two bronchi are also hollow tubes and supported by cartilage. And they, too, divide – into lower airways called bronchioles.
Bronchioles are thin hollow tubes that remain open and lead to the alveoli. The alveoli – small sacs that form the end of the airway – number in the millions. Each alveolus shares a wall with capillary blood vessels. This point, where the walls of the alveoli and the walls of the capillaries come into contact, is where external respiration takes place – that all-important exchange of oxygen and carbon dioxide between the respiratory and circulatory systems.