Kneel beside the victim’s head. Maintain an open airway (refer to ANZCOR Guideline 4).
Take a breath, open your mouth as widely as possible and place it over the person’s slightly open mouth.
While maintaining an open airway, pinch the nostrils (or seal nostrils with rescuer’s cheek) and blow to inflate the person’s lungs.
Because the hand supporting the head comes forward some head tilt may be lost and the airway may be obstructed.
Pulling upwards with the hand on the chin helps to reduce this problem. For mouth to mouth ventilation, it is reasonable to give each breath in a short time (one second) with a volume to achieve chest rise regardless of the cause of cardiac arrest.
Care should be taken not to over-inflate the chest. Look for rise of the chest during each inflation. If the chest does not rise, possible causes are:
• obstruction in the airway (tongue or foreign material, or inadequate head tilt, chin lift)
• insufficient air being blown into the lungs
• inadequate air seal around mouth and or nose.
If the chest does not rise, ensure correct head tilt, adequate air seal and ventilation. After inflating the lungs, lift your mouth from the person's mouth, turn your head towards their chest and listen and feel for air being exhaled from the mouth and nose.
Mouth to neck stoma, A person with a laryngectomy has had the larynx (voice box) removed and breathes through a hole in the front of their neck (stoma). A stoma will be more obvious when the person is on their back for Rescue Breathing and the head is put into backward tilt.
If a tube is seen in the stoma, always leave it in place to keep the hole open for breathing and resuscitation. The rescuer should place their mouth over the stoma and perform rescue breathing as described above.
If the chest fails to rise, this may be due to a poor seal over the stoma, or the person having a tracheostomy rather than laryngectomy thus allowing air to escape from the mouth and nose or a blocked stoma or tube. If stoma or tube is blocked use back blows and chest thrusts in an attempt to dislodge the obstruction (Refer to Guideline 4).