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.
Bag and mask ventilation
The patient can be artificially ventilated using a face mask and an Ambu bag. After clearing the airway, the hold an anesthetist’s mask firmly over the victim’s nose and mouth with the left hand, the angle of the lower jaw held forwards to prevent the tongue from falling back. The bag is alternately compressed and released by the right hand. The valve in between the bag and the mask permits air to pass into the victim’s airway when the bag is compressed and allows it to flow to the atmosphere when the bag is released.
Johnson and Johnson’s resustitube can be used instead of mouth to mouth ventilation. It is a 17.5 cm long plastic tube with a diameter of 1.8 cm. There is a plastic cover 8.75 cm in diameter. It fits snugly over the mouth and prevents escape of air during artificial ventilation. Lower part of the tube is curved to fit over the tongue and thereby prevents the tongue from falling back. The tube is placed in the victim’s mouth and mouth to tube ventilation is done.