Could You Save a Life?

COULD you, in an emergency, save a person’s life? An American living in the Dominican Republic suddenly faced that question not long ago. The life in jeopardy was that of the human he loved most​—his wife.

His wife had been sick with the flu for a few days and was confined to bed. He had not considered her illness to be serious; she was only in her late twenties and had been in relatively good health. So on returning home one day for his noon meat he was shocked to find her unconscious. Checking closer, he found no evidence of breathing. ‘She is dead,’ was the thought that immediately flashed through his mind. What could he do?

He remembered reading some articles on artificial respiration. No, not the back-pressure arm-lift method, but the new mouth-to-mouth resuscitation method. Immediately he placed his mouth to the mouth of his wife and started the process as best he could remember it. But he was not doing it just right, for the air he blew into her mouth came out her nose. Then he remembered that the nose of the victim must be held closed to allow the air to enter the lungs. He tried this, and it worked.

In the meantime a neighbor came by, saw the situation, and immediately ran down the street to the home of a doctor. At the moment the doctor was attending a patient, and was in no hurry to leave. However, when convinced that it was an emergency, he came. The doctor later noted that the woman’s life had been saved by her husband’s quick action.

Emergencies Not Uncommon

It is possible that you may face a similar emergency. For in the United States alone an estimated 350,000 persons die suddenly each year. Most of these sudden deaths are from heart attacks, but many others are from gas poisoning, electrocution, drowning, suffocation and other accidents. Some experts believe that thousands of these persons could have been saved if they had received immediate help.

Illustrating what can be done is the experience of a fifty-four-year-old airline executive who collapsed on a Seattle, Washington, golf course last spring, victim of a heart attack. Several nearby youths sped to help him. No signs of breath or pulse were evident; the man had turned dark blue from lack of oxygen. From the moment breathing stops, a person can usually survive only about four to six minutes before permanent damage is done to the brain due to lack of oxygen.

So as one youth immediately began mouth-to-mouth respiration, another placed one hand on top of the other on the man’s chest and started rhythmic, strong compressions, about one per second. Each time he pressed down, the man’s heart was, in effect, squeezed, sending oxygen-carrying blood out toward the brain, just a few inches away. These repeated compressions also may stimulate the heart to beat on its own again.

Shortly, the man’s blue color began to fade. He was getting life-sustaining oxygen! Later, firemen arrived with an air-bag device to substitute for the mouth-to-mouth respiration. Thanks to the quick action of the boys, the man was still alive. Three weeks later, in mid-April, he left the hospital, without permanent heart or brain damage!

These youths are among thousands of persons in Seattle and other cities who have received training in lifesaving techniques. Actually, these techniques are new to most persons, being unknown even to most doctors before 1960. Mouth-to-mouth artificial respiration was developed just since the late 1950’s. This was as a result, in part, of an emergency that occurred during a backyard picnic in Croton-on-Hudson, New York, in June 1957.

Lifesaving Technique Rediscovered

It was suddenly discovered on that Sunday afternoon that the host’s two-and-a-half-year-old boy was missing. Moments later he was found, floating feet up in the swimming pool. He was pulled out, his face and body bloated and his skin bluish gray, and laid on the grass. No heartbeat or pulse could be detected. After attempting without success the then recommended back-pressure arm-lift artificial respiration method, the father was desperate. In a widely read magazine article, he explained:

“What happened next remains a puzzle to me, because to my recollection I had never heard or read of anyone else doing what I did.

“I saw that Geoffrey’s mouth and throat were full of liquid mixed with what looked like food particles, and I figured that this stuff had to come out if air were to go in. I leaned over my son, held his mouth open with my left hand, put my mouth to his. Then I sucked until the liquid and material came out, spat it out, sucked again until the mouth was clear.

“Then something​—what? how?​—told me that I might force air into his lungs by blowing down his throat. I took a deep breath and blew gently into his mouth. . . . I kept blowing . . . Suddenly a gurgling sound came from the child. His chest seemed to be moving slightly. I placed my cheek close to his mouth; air seemed to be moving in and out of it.”

The child, on being rushed to the hospital, was placed in an oxygen tent. Several days later he came home, recovering fully from the near tragedy with no ill effects.

When two doctors heard of the experience, they were extremely interested. A short time later the father was invited to speak in Buffalo, New York, to a convention of some 200 doctors, medical students and representatives of professional rescue groups. He explained to them how he had saved his son, and answered questions. But the question he could not answer was: “Where did you learn how to do this?”

This is because back in 1957 mouth-to-mouth artificial respiration was virtually an unknown technique. Apparently it was used in centuries past, but the method had long since been generally forgotten. It was rarely mentioned anywhere.

For example, The Encyclopædia Britannica and The Encyclopedia Americana, in their 1950 editions under “Artificial Respiration,” describe only the method whereby the victim is laid on his stomach and a person forces his lungs to work with pressure on his back and by lifting his arms. The 1957 edition of the American National Red Cross book, First Aid, also recommends this back-pressure arm-lift method.

Medical Opinion Changes

But as more and more persons reported success with mouth-to-mouth artificial respiration, a change began to be made. The above-mentioned First Aid book added a section, beginning on page 242, explaining: “This appendix supercedes material on pages 117-125 [where the back-pressure arm-lift method is recommended and described].” The appendix says:

“The National Academy of Sciences National Research Council Ad Hoc Committee on Artificial Respiration in its meeting of 3 November 1958 reviewed the data on artificial respiration . . .

“It was unanimously agreed by members of the Ad Hoc group that the mouth-to-mouth (or mouth-to-nose) technique of artificial respiration is the most practical method for emergency ventilation of an individual of any age who has stopped breathing.”

The mouth-to-mouth method supplies a greater volume of air to the victim, up to twelve times the amount averaged by experts using other methods. Also, the very position in which the victim is placed in administering mouth-to-mouth artificial respiration​—on his back with his head tilted back as far as his neck will stretch—​facilitates breathing because it opens the mouth-to-lungs airway.

Thus a change was made in the recommended method of reviving a person who has stopped breathing. Reader’s Digest, August 1959, noted: “Nineteen fifty-nine will be marked down as a year of revolution in artificial-respiration methods. . . . nearly every major first-aid organization in the country is rewriting its official literature to make mouth-to-mouth artificial respiration​—often called ‘rescue breathing’—​the first choice in resuscitation emergencies.”

Closed-Chest Heart Massage

An even newer lifesaving technique is the squeezing of the heart by controlled hand pressure on the chest. It reportedly was originated in 1960 by a Johns Hopkins University medical team. However, for the blood forced out from the heart to contain vital oxygen, air must be supplied the lungs. This is why mouth-to-mouth artificial respiration is valuable in combination with this technique​—as illustrated by the revival of the airline executive by those youths on that golf course last spring.

If the victim’s heart has stopped for more than five minutes or so, the situation is hopeless, for irreparable damage has been done to the brain. However, apparently hopeless cases have been successfully revived, even after an hour of heart massage. This is because the heart may sometimes still beat, although the heartbeat cannot be detected without the aid of a stethoscope. So in cases of sudden heart stoppage, real or apparent, you may be able to save the victim by doing the following:

Place the heel of your right hand on the lower half of the victim’s breastbone, and your left hand atop the right. Then press the breastbone inward one and a half to two inches with a quick forceful thrust at a rate of sixty compressions per minute. At the same time someone else should be administering mouth-to-mouth artificial respiration.

Certain ones have recommended, however, that closed-heart massage should not be used except by those specially trained in it. Even when used correctly, cracked ribs can result. And when incorrectly done, the liver or a lung may be punctured by a broken rib. However, because of its proved value, the 20,000-member American College of Physicians has recently recommended that a nationwide educational program be launched to teach the general public this procedure, as well as mouth-to-mouth artificial respiration.

An Easily Learned Technique

Resuscitation by mouth-to-mouth breathing is a simple first-aid measure that any adult or older child can learn. Since it can save another’s life, there is certainly good reason for you to want to learn the method if you do not already know it. Many persons, without any previous experience or special training in its use, have employed the method to save lives.

Since an unconscious person may have only fainted, the first thing to do is to see if he is breathing. Do this by placing your ear close to his mouth, with your face turned toward his chest. If he is breathing, you should be able to feel his breath in your ear, and perhaps observe chest movements.

If there is no indication of breathing, make sure that his air passage is open. Sometimes the tongue of an unconscious person sags backward in the throat, cutting off this vital air passageway to the lungs. Also, blood, vomitus, saliva or half-swallowed objects can seal the airway.

Restoring an Open Airway

Opening the airway to the lungs, therefore, is the most important action you can take to help a person breathe again; in fact, it may be all that is necessary to restore breathing. Usually it is not hard to open an obstructed airway.

With the unconscious person lying on his back, first lift his neck. This will cause the head to drop backward, extending the neck. But in addition, roll the head back fully, until it will go no farther. You may be surprised how far back the head will go with full neck extension. Having done this, the chin will be pointing almost straight upward, with the crown of the head resting on the floor. In this position the jaw and tongue are drawn forward and the airway in the throat is cleared.

At times, however, it may also be necessary to clear the mouth and throat of blood, vomit, food debris, or other obstructions. To do this, wrap a clean handkerchief or a paper tissue around your fingers and clear out the obstructions. If a handkerchief or suchlike item is not available, use your fingers. You will recall that the father rescuing his son sucked debris out with his own mouth and then spit it out.

Mouth-to-Mouth Resuscitation

If this quick clearing of the airway does not restore breathing, begin immediately to give artificial respiration. Quick action is vital. Remember, the unconscious person can live only about four to six minutes without breathing. So your purpose is to do the work of normal breathing for the person by forcing air in and out of his lungs.

Open your mouth wide and place it directly on the mouth of the victim, making a tight seal. Then pinch his nose shut, and blow into his mouth until you see his chest rise and feel his lungs expand. Or you can blow into his nose and hold his mouth shut. If the victim is a small child, put your mouth over both his mouth and nose and blow in air.

As you blow, the person’s lungs should fill with air and his chest expand. If this does not occur, there is probably still some obstruction in the airway. In that case, turn the person on one side with his head tilted downward and administer sharp blows between the shoulder blades. This may dislodge the object. A child can be held upside down by the heels and given blows between the shoulder blades, the strength of which depends on the child’s size.

When the airway is open and after you have blown air in, what should you do next? Remove your mouth and take another breath as you listen for the air to leave the victim’s lungs; also watch for his chest to go down. Then blow air in again, repeatedly inflating his lungs at the rate of ten or twelve times per minute for an adult, and at least twenty times per minute for a child. Give an adult more vigorous puffs of air, a child smaller puffs. It is important that the head of the person all the while be properly tilted to keep the airway open.

As the victim starts to breathe by himself, his breaths will be shallow and weak. So time your inflations to coincide with his weak breaths. Continue to help him to breathe until it is judged that his breathing is satisfactory.

If after a while your efforts at artificial respiration are unsuccessful in starting the victim’s own breathing, you might interrupt about every two breaths with five or six closed-chest heart maneuvers. Do not give up hastily. Persons have revived after an hour or more of resuscitation efforts.

A Repugnant Method?

Some have objected to mouth-to-mouth resuscitation for aesthetic reasons. A British surgeon, for example, said that its use is repugnant “when you’re faced with a possible corpse.”

True, some may feel that way. But many others will feel like the woman who did not hesitate to try to save a heart-attack victim. “In such an emergency,” she said, “you do not think about the process being repugnant. All you think about is what you can do to assist the helpless person.” A person can, if he desires, place a clean handkerchief between his mouth and that of the victim.

Tragedy often strikes when least expected. We never know when one of our loved ones, or someone else, may suddenly stop breathing due to a heart attack or accident. How fine it is if we know how to administer first aid that could save another’s life!

[Picture on page 11]

Before administering mouth-to-mouth resuscitation, open airway by lifting the back of the person’s neck and tilting the head back as far as the neck will stretch. Pinch his nose shut and blow into his mouth until you see his chest rise and feel his lungs expand. Repeat lung inflations twelve times per minute