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/chest pressure method (Silvester)
Place the patient face upwards.
Place a folded blanket under his shoulders to raise them so that the head falls backwards.
Kneel near the head.
Grasp his forearms near his wrists, cross them over to the lower part of the chest and then lean forward to press the crossed arms for 2 seconds.
Then pull the arms upwards and outwards with a sweeping movement and place them on the ground by your own knees for 3 seconds.
Repeat the cycle 12 times a minute.
This method is useful when the victim cannot be placed face down. It is more effective than the prone pressure method.