Basic Life Support (BLS) involves immediate actions to sustain life during emergencies such as cardiac or respiratory arrest. A central component of BLS is rescue breathing, which provides oxygen to individuals who are not breathing adequately but still have a pulse. Recognizing the signs of respiratory distress and knowing the proper breathing rates for different age groups is crucial for effective emergency aid.
Age-Specific Breathing Rates in BLS
The appropriate rate for administering rescue breaths varies depending on the age of the individual receiving aid. For adults, when a pulse is present but breathing is absent or ineffective, rescue breaths should be delivered approximately once every five to six seconds. This translates to a rate of about 10 to 12 breaths per minute.
For children, typically defined as those from one year of age up to puberty, the recommended rate is one breath every three to five seconds. This results in a slightly faster pace of about 12 to 20 breaths per minute. When two rescuers are present for a child with a pulse but no or abnormal breathing, the rate may be increased to one breath every two to three seconds, totaling 20 to 30 breaths per minute.
Infants, up to one year of age, require rescue breaths at a rate of one breath every three to five seconds, equating to 12 to 20 breaths per minute. If a single rescuer is present, the rate may align with adult guidelines at one breath every six seconds, resulting in 10 to 12 breaths per minute. However, when multiple rescuers are involved, the rate for infants can be one breath every two to three seconds, or 20 to 30 breaths per minute, similar to children. These age-specific rates ensure that the individual receives adequate oxygenation without causing harm from over-ventilation.
Administering Rescue Breaths
Delivering rescue breaths effectively requires specific techniques to ensure air reaches the lungs. The initial step involves opening the airway, most commonly achieved using the head-tilt/chin-lift maneuver. This involves placing one hand on the forehead and tilting the head back, while lifting the chin forward with the other hand. This action helps to move the tongue away from the back of the throat, which can otherwise obstruct the airway. If a neck injury is suspected, a jaw-thrust maneuver should be used instead to avoid further spinal damage.
Once the airway is open, the rescuer must create a proper seal over the individual’s mouth and pinch their nostrils shut. This prevents air from escaping through the nose rather than entering the lungs. Each breath should then be delivered steadily over approximately one second, providing enough air to cause the chest to visibly rise.
Observing the chest rise confirms the breath successfully entered the lungs. If the chest does not rise, the rescuer should quickly reposition the head and chin, then attempt another breath. Avoid delivering breaths too rapidly or with excessive force, as this can force air into the stomach rather than the lungs. Using a barrier device, such as a pocket mask, is also recommended to protect the rescuer.
The Critical Role of Oxygenation
Oxygenation is essential in emergencies because the body’s cells, especially in the brain and heart, need a continuous supply of oxygen. Without adequate oxygen, these vital organs can suffer irreversible damage within minutes. Respiratory arrest, where breathing ceases or becomes ineffective, often precedes cardiac arrest if not promptly addressed.
Rescue breaths provide the necessary oxygen to prevent this progression and sustain organ viability. Even the oxygen present in exhaled air, which is about 17%, can be sufficient to support life in an emergency. When available, administering supplemental oxygen at 100% concentration is recommended during Basic Life Support to maximize oxygen delivery to tissues.
Delivering oxygen effectively during resuscitation is important for maintaining aerobic metabolism and the production of adenosine triphosphate (ATP), the body’s energy currency. Without sufficient re-oxygenation of compromised tissues, particularly the heart muscle, the return of spontaneous circulation (ROSC) cannot be achieved. Short-term use of 100% oxygen during these moments is beneficial and does not pose a risk of oxygen toxicity.