Oxygen Administration: Live Breathing Exercise

by

Larry "Harris" Taylor, Ph.D.

 This material is copyrighted and the author retains all rights. This article is made available as a service to the diving community by the author and may be distributed for any non-commercial or Not-For-Profit use.  

All rights reserved.

 This article is based on material once presented in the authorís DAN O2 Provider Class.  

 

Although no longer done in current classes, the author suggests it is a valuable experience for those already trained in rescue breathing . 

The author believes every diver should have DAN O2 training (or its equivalent).

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There is absolutely no doubt that ventilating a non-breathing human being is distinctly different from blowing into a plastic replica of a human being with no arms or legs, incredible airway resistance, and the need for head tilt angles that would cripple an actual human being. Under the premise that training should be as close to an actual situation as possible, the exercise described below was used by the author during the first decade of his DAN O2 training classes. It is now (and has been for a couple of decades ... because it involves real people) forbidden during classes. However, even though the author no longer does this exercise in class, the author encourages people, after and outside of any first responder class to try this exercise to experience the ease of human ventilation. 

Unless rescue is part of a daily routine, a normal non-professional rescuer faced with a non-breathing (and often personally known) victim will be flooded with the desire to assist and, as a consequence, their body will dump massive amounts of adrenalin (epinephrine) into their metabolic system while mobilizing the entire arsenal of "fight or flight" biochemical stress-response reactions. The desire to help can overwhelm and the rescuer will face an increasing need for speed  to more quickly assist the non-breathing victim which, if unchecked, can rapidly incapacitate the rescuer.

When learning rescue breathing, instructors always point out the necessity for the rescuer to count out-loud. The vocalization is a key component of rescue technique for the following reasons:

1. The out load counting (one-one-thousand, two-one-thousand, ... etc.) forces the rescuer to slow down and assume a reasonable pace. This greatly extends the length of time the rescuer can physically sustain the rescue effort. (Without vocalization of count, the typical person will continually increase speed until physical exhaustion terminates the rescue effort.)

2. The vocalization acts like a metronome to stabilize the rhythm of the rescue effort. This is particularly important if a two-person technique is being employed.

3. The auditory system is one of the last senses to shut down. As such, a person apparently dead to the world can, after regaining consciousness, remember everything said during the rescue effort. It is known that people who do not give up can survive massive traumas while those who give up have lost their lives to seemingly minor injuries. It just may be that hearing a human voice counting in rescue mode can furnish a non-breathing person a reason to not give up (i.e. someone is trying to help me, so I will continue my fight to survive).

4. The author tells students that in a rescue scenario, it is safest to assume everyone other than the victim is either a reporter or an attorney (neither one of which is a friend to the rescuer). In a post incident world (and the now-mandatory litigation) witnesses can recall a rescuer whose loud metronome-like counting created an atmosphere of calm control. This may be legally beneficial to the rescuer.

5. Lastly, the counting can be a trigger for the exercise I now describe.

In practicing rescue breathing on a live person, the hardest task to accomplish is for the apparent victim to allow another to breath for them. The counting of the rescuer serves as a clue to the simulated non-breathing  victim. So, this is how the exercise (only for one person breathing into another person with a pocket mask; not for use with mechanical positive pressure devices) is performed. The technique is the same as taught in oxygen provider/rescue breathing with a pocket-mask class, except that ventilation is done on a person, not a manikin.

The victim is in the supine (flat on the back) position. The rescuer kneels at the head of the victim. The rescuer uses gloves and a pocket mask (with or without oxygen supplement) equipped with the HEPA filter to minimize disease transmission risk.  After the head is properly positioned, the rescuer counts out-loud;  one-one-thousand, two-one-thousand, three-one thousand, four one-thousand, breathe. During the breathe word, the rescuer slowly breathes into the pocket mask which has been sealed over the victim's mouth and nose.

The victim listens to the count of the rescuer and exhales when the rescuer counts three-one thousand.

Since the victim exhales on three, when the rescuer reaches four one-thousand, the victim's lungs are relatively empty and can be filled by the rescue breathing.

When the rescuer slowly breathes (for about one second) into the pocket mask, they can feel the pressure increase as the victim's lungs inflate; they can see the chest rise. The rescuer senses what it is like to breathe for another. The rescuer learns that breathing for a human is easier than breathing into a manikin. The rescuer then believes that they truly posses the ability to breathe for another.

When done properly, the victim does not need to consciously breathe; the rescuer is doing the breathing.

Completion of this exercise leaves both rescuer and victim with a new appreciation of rescue breathing, an awareness of the sensations associated with  successful ventilation, and a confidence in their ability to sustain the breathing of an non-breathing person via the rescue breathing with a pocket mask technique. It has been described by students as the single most valuable aspect of their oxygen provider training.

Bottom line: it is easier to ventilate a person than a "peoplekin" (The author was once in an advanced rescue class where someone suggested that the term manikin was sexiest and, as such,  the non-gender specific term, "peoplekin" should be used ... but, since the author has never heard a plastic CPR training aid complain of verbal gender abuse, he still uses the term manikin.) and since nothing is more convincing than success, the above exercise can be a valuable learning experience.

Mandatory Legalese: This exercise has been performed by the author hundreds of times without harm or injury. However, since this exercise would be performed outside of a supervised class, all liability is assumed by those participating in the drill.

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 About the Author:

Larry "Harris" Taylor, Ph.D. is a biochemist and Diving Safety Coordinator at the University of Michigan. He has authored more than 100 scuba related articles. His personal dive library (See Alert Diver, Mar/Apr. 1997, p. 54) is considered by one of the best sources of information in North America.

  Copyright 2001-2013 by Larry "Harris" Taylor

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Use of these articles for personal or organizational profit is specifically denied.

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