In certain situations, mouth to mouth respiration cannot be given e.g. when the face is damaged, the lower jaw is fractured, or the lips and mouth have been burned by a poison. In such cases, manual methods are used.
Arm-lift/back-pressure method (Holger Nielsen)
- Place the victim on the ground; face down, the forehead resting on the back of the overlapping hands.
- Keep the straight, so as to keep air passages completely open and free.
- Kneel near the victim’s head, placing one knee near his head and the opposite foot by the side of the corresponding side elbow. The knee and foot may be alternated from time to time.
- Place both hands over the lower pats of the victim’s shoulder blades, the fingers spread and the thumbs near midline. Keep the arms and forearms straight; lean forward so as to apply pressure by the weight of the upper part of the body.
- Count one-two and then lean back, sliding hand to just above elbows of the patient, as you count three.
- Grasp the arms of the victim near the elbows and lift them up, keeping upper limbs straight. Count Four-five and then lower Patient’s arms back to original position as you count six.
- Then start all over again.
This method is not suitable if the patient has injuries of the chest wall or fractures of the arms.