When an individual has a pulse but is not breathing, it signals a medical emergency requiring immediate intervention. This situation, known as respiratory arrest, means the body is not receiving oxygen, which can quickly lead to severe brain damage or cardiac arrest. Acting promptly can significantly improve the outcome.
Recognizing the Emergency
Begin by checking for responsiveness; gently tap the person’s shoulder and shout loudly, asking if they are okay. If there is no response, proceed to assess their breathing. Look for the rise and fall of the chest, listen for breath sounds, and feel for air movement from their mouth or nose for no more than 10 seconds.
Simultaneously, check for a pulse. For adults and children, locate the carotid artery in the neck by placing two or three fingers in the groove between the windpipe and the neck muscles. For infants, check the brachial pulse on the inside of the upper arm, between the elbow and shoulder. This pulse check should also take no more than 10 seconds; if a pulse is present but breathing is absent or abnormal, immediate action is necessary.
Activating Professional Help
Immediately call for emergency medical services. In the United States, dial 911, or your local emergency number elsewhere. Make this call without delay, even before initiating other interventions, to ensure professional medical assistance is en route.
When speaking to the dispatcher, provide clear and concise information about your location, the nature of the emergency, and the person’s condition, specifically stating that they have a pulse but are not breathing. If another bystander is present, direct them to make the call while you prepare to provide care. This coordinated effort allows for simultaneous activation of the emergency system and preparation for life-sustaining support.
Performing Rescue Breaths
Once emergency services have been contacted, the next step involves initiating rescue breaths to supply oxygen to the person’s lungs. Begin by positioning the individual on their back on a firm, flat surface. This stable base ensures effective delivery of breaths and allows for proper body alignment.
To open the airway, perform the head-tilt, chin-lift maneuver. Place one hand on the person’s forehead and gently tilt their head backward. With the fingers of your other hand, lift the bony part of their chin upward to move the tongue away from the back of the throat, creating an open passage for air. For infants, avoid overextending the neck and aim for a neutral head position.
After opening the airway, pinch the person’s nose shut with the hand on their forehead to prevent air from escaping. Create a tight seal by covering their mouth completely with your mouth. For infants, you may need to cover both their mouth and nose with your mouth due to their smaller facial features.
Deliver a rescue breath lasting about one second, observing for visible chest rise. If the chest does not rise, re-adjust the head-tilt, chin-lift and attempt a second breath. Avoid delivering breaths too rapidly or forcefully, as this can force air into the stomach, potentially causing complications.
The frequency of breaths varies based on age. For adults, deliver one breath every 5 to 6 seconds, totaling about 10 to 12 breaths per minute. For children and infants, the rate is slightly faster, at one breath every 3 to 5 seconds, which translates to approximately 12 to 20 breaths per minute. Continue delivering these rescue breaths consistently.
Sustaining Support Until Assistance Arrives
Once rescue breaths have begun, it is important to continue this life-sustaining support without interruption. Maintain the established rhythm of rescue breaths until one of three conditions is met. The first is if the person begins to breathe normally on their own, indicating a return of spontaneous respiration.
Secondly, continue until professional medical help arrives and is prepared to take over care. Paramedics and other emergency responders have specialized equipment and training to manage the situation further. Finally, if you become too exhausted to continue providing effective breaths, you should stop, but only as a last resort.
Throughout this period, closely monitor the person for any changes in their condition, including a return of spontaneous breathing or a loss of pulse. If at any point the pulse stops, and you are trained, you would then transition to cardiopulmonary resuscitation (CPR) which includes chest compressions. Maintaining a calm demeanor helps ensure effective care and allows you to clearly communicate the situation and interventions performed to the arriving medical team.