Choking, drowning, electrical shock, auto or sports accidents, poisonous gas, suffocation, stroke and other medical problems can interrupt breathing. When a person stops breathing, it is a serious emergency. The individual’s chest does not move; his or her face and skin become bluish; there is no exhaled breath. Once breathing has stopped, permanent brain damage or death can result in four to six minutes.

Every second matters.

Rescue breathing can save lives. Do not loosen clothing or warm the victim before beginning rescue breathing. Likewise, do not move the victim unless he or she is lying in a dangerous place. It is more important to know the steps of emergency breathing assistance and to begin immediately:

• While someone else calls 911 or goes for medical help, position the victim face up. Remove foreign objects or matter from the mouth or airway.

• Place one hand on the victim’s forehead. Use your other hand to lift under the chin or base of the head, tilting the head back slightly to open the airway. Check to see if breathing has resumed. If not, continue rescue breathing techniques.

• Pinch the victim’s nostrils shut. Place your mouth over the victim’s open mouth (or mouth and nose for children less than 6 years old), breath slowly into the victim, two full breaths, while watching for the chest to rise. Use only small puffs of air for infants. Remove your mouth between breaths, allowing the victim’s chest to fall.

• Continue breathing into the victim’s mouth, one breath every five seconds (every four seconds for a child and every three for an infant), until the victim begins to breathe without help or until emergency medical personnel arrive. If the victim’s chest does not rise during your attempts at rescue breathing, then the airway may be blocked. Try turning the victim’s head to one side and clearing the mouth of any foreign matter with your fingers. If that does not help, try the Heimlich maneuver. This involves a series of under-the-diaphragm abdominal thrusts designed to force enough air from the victim’s lungs to create an artificial cough and expel obstructions from his or her airway.

Article by Dr. Berhan Ghermay, medical director for emergency services at St. Elizabeth Hospital in Enumclaw. The hospital is part of the Franciscan Health System. Visit Franciscan online at www.FHShealth.org.