Comparison of Methods for Performing Manual Artificial Respiration on Apneic Patients

Abstract

Gordon et al. have emphasized that "push-pull" methods (active expiration plus active inspiration) of manual artificial respiration are considerably more effective than those which either "push" or "pull," but do not combine both. The Schafer method has only one active component (expiration with prone pressure) and is the least effective of all currently available methods. A number of methods combine an active expiratory component with an active inspiratory phase. The authors found the hip-lift backpressure method to be the most effective of these, and believe that it should be used whenever the operator is strong and the patient is light, or when artificial respiration is needed for only a few minutes. The Nielsen method was less effective than the hip-raising procedures, but superior to the Schafer method. It probably represents the most practical method available for producing adequate pulmonary ventilation in most individuals in need of artificial respiration for long periods. It should be used with a full arm lift at a rate of 15 per min. or more. Failure to do so may result in hypoventilation in some patients.. No one method of manual artificial respiration is ideal for all situations. Both the hip-lifting technics and Nielsen procedures should be learned by those who most often encounter apneic patients. The hip-lift back-pressure, hip-roll back-pressure, Silvester, Schafer and Nielsen methods for manual artificial respiration were compared on 4 non-breathing hospital patients. The hip-lifting procedures produced the greatest tidal volumes and the Schafer method the least. Additional studies were performed in 8 apneic, anesthetized female patients. Although the Nielsen method produced less pulmonary ventilation than the hip-lifting procedures, it appeared to be a convenient and practical method for giving artificial respiration for long periods of time.