Expired Air Resuscitation in Shallow

water

What is EAR
- Also known as rescue breathing, EAR is used to restore breathing for casualties
suffering from respiratory arrest.

Why does it work

- Exhaled air contains about 17% oxygen which is sufficient to keep someone alive as
we use only about 4% out of the 21% of oxygen we breathe in.
- As an average human breathing rate at rest is 10-12 inhalations per minute, 12 rescue
breaths per minute is used to supply oxygen to the casualty.
- The average volume of air inhaled for an adult at rest is 400-600ml, while the vital
capacity of a child is much larger, hence a child will be able to perform EAR on an
adult.

When do you perform EAR

- Casualty is not breathing (respiratory arrest) or gasping (agonal respiration).
- Environment is unsuitable for Cardiopulmonary Resuscitation - untrained rescuer,
victim is still in the water.
- Help is still on the way.

Child EAR (under 8 years old)

- Lower lung capacity, faster breathing rates than adults.
- Child: Smaller volume of air. 4 sec per EAR cycle (approx 15 breaths/min)
- Infants: Puffs of air given for infants. 3 sec per EAR cycle (approx 20 breaths/min)
- Mouth-to-mouth & nose for infants.

Created by Dickson 2017

Complications

1. Airway obstruction
- Caused by obstructions in the airway.
- Remove foreign objects if possible. (Tongue-Jaw lift)
- Redo head tilt chin lift and ensure a tight seal between the casualty’s mouth and your
mouth.

2. Abdominal distension (Air in the stomach)

- Caused by overinflation, too forceful inflation, partially blocked airway.
- May lead to regurgitation.
- Redo head tilt chin lift and reduce pressure and volume used to blow.

3. Vomiting and Regurgitation

- Caused by the body’s rejection of stomach contents, mainly water for drowning
victims.
- May be a sign of recovery.

Created by Dickson 2017

Scenario (Shallow water EAR)
You are in a condominium pool (1.2m) with a friend and you notice a swimmer turn unconscious. You
immediately asked your friend to call for help and went to rescue the guy. Upon retrieval of the victim,
you realise he is not breathing. While waiting for your friend to get back to assist in removal of victim
from the water, you initiate EAR. After a couple of rescue breaths, the victim resumes breathing. He is
brought up and monitored closely while waiting for the paramedics.

How do you perform EAR (DRSABC)

-Based on the above scenario, tick the relevant steps to be used.

Danger
❏ Danger to yourself, bystanders , victim

Response
❏ Movement
❏ Sound
❏ Touch
❏ Pain

Shout for help

❏ “Call 995 for an ambulance and get back to me”
❏ “Get an AED” (If Trained)

Airway
❏ Head-Tilt Chin-lift
❏ Jaw Thrust

Breathing
❏ Check for 10 Seconds
❏ Look for chest rising and falling
❏ Listen to breathing sounds
❏ Feel the warm and moist breath on your cheeks
❏ When no breathing, give 2 initial blows (To open the airway due to laryngospasm)

Commence EAR
❏ 1 second blow , 4 seconds for air to be exhaled
❏ Pinch the nose and blow into mouth (mouth-to-mouth)
❏ Pistol grip on the mouth and blow into nose (mouth-to-nose)
❏ Use a resuscitation mask to deliver blows (mouth-to-mask)
❏ Blow into mouth and nose (Mouth-to-mouth and nose)
❏ Repeat for 12 cycles before checking for breathing again
❏ Stop when paramedics has arrived/casualty resumes breathing

Created by Dickson 2017