Blocked airway
If the victim’s chest does not rise with inflation, check that:
- the head is tilted back, and the jaw is lifted correctly
- the seal of your mouth or resuscitation mask is firm
- there is no foreign material in the airway
- enough air is being blown in.
Vomiting and regurgitation
Vomiting is an active process in which muscular action makes the stomach eject its contents upwards. It is nearly always accompanied by a loud noise. You will usually know when a victim is vomiting or is about to vomit.
Regurgitation is the silent flow of stomach contents into the mouth and nose. It is the silence that makes regurgitation dangerous, as it may be very difficult to detect.
Both are extremely common during resuscitation, especially in cases of drowning where large amounts of water may be swallowed. Every victim who has vomited or regurgitated should immediately be rolled into the lateral position.
A person who regurgitates or vomits while lying face up (supine position) is very likely to inhale some of the stomach contents into the lungs, which may lead to serious lung damage and infection. Once a victim has regurgitated or vomited, it is essential that the victim be rolled onto their side immediately to clear any materials, then assess the breathing (See Rolling a victim onto their side).
Distension of the stomach
In cases of drowning, the victim’s stomach is often swollen at the time of rescue. This swelling of the stomach most often occurs because they have swallowed water and air in the process of drowning.
Stomach swelling may be made worse if rescue breathing is performed with the airway partially blocked by the tongue or foreign material, if you blow too hard, or if you blow too much air.
A distended stomach can be recognised by a persistent and possibly increased swelling in the upper part of the victim’s abdomen. It leads to increased upward pressure on the diaphragm, making rescue breathing more difficult. It also greatly increases the risk of regurgitation.
No attempt should be made by lifesavers to reduce the swelling of a victim’s abdomen; treatment of this condition should be left to ambulance paramedics or hospital staff. Check that all of the ARC guidelines for correct rescue breathing are being followed and that the airway is not blocked.
Further stomach distension can be prevented by:
- following the ARC guidelines for maintaining a clear airway
- watching for the rise and fall of the chest
- blowing only until you see the chest rise
- not blowing too quickly.