Breathing should initially be checked when the patient is on their back, as this saves time. If the rescuer was required to roll the patient to clear the airway, breathing can be checked on their side. In both cases, keep your hands on the head (1 in pistol grip, 1 on head tilt) while you look, listen, and feel for signs of normal breathing. Do not let go of the head while assessing for breathing.
- Look (with your eyes) for movement of the chest and upper abdomen.
- Listen (with your closest ear) for sounds of normal breathing, with your ear close to the patient’s nose and mouth.
- Feel (with your cheek) for any movement of air from the patient’s mouth or nose with your cheek.
Note:
- The decision on whether the patient is breathing normally is usually straightforward. If you are uncertain, it is safer to assume someone is not breathing normally and start CPR. Do not withhold CPR if you aren’t sure – more harm is done by not starting CPR on someone who needs it than starting on someone who doesn’t.
- Do not mistake the occasional gasp for normal breathing; this is not normal breathing, and the patient requires CPR.
- Movement of the lower chest and upper abdomen does not necessarily mean the person has a clear airway. Paradoxical (see-saw) breathing can indicate an obstructed airway. Check your head tilt and chin lift.
Patient is not breathing normally
Commence CPR if the patient is unconscious and not breathing normally.
Be aware that any overinflation may cause a patient’s stomach to inflate, making CPR more difficult and increasing the risk of regurgitation and aspiration into the lungs – breaths should only be given until the chest is seen to begin to rise.
Patient is breathing normally
If the patient is breathing normally and unconscious, place them in the recovery (lateral) position while monitoring and keeping them safe and warm, as described in rolling the patient for a patient with a blocked airway.
