EXPIRED AIR RESUSCITATION (EAR) is the method by which a rescuer breathes for a casualty who is in respiratory arrest. The common term is 'mouth-to-mouth resuscitation'. It is a most effective method for sustaining life, as a rescuer breathes out sufficient oxygen to supply a casualty with the necessary requirement.

 
There are five methods for delivering EAR:
MOUTH-TO-MOUTH where the rescuer seals the casualty's mouth with his or her mouth and breathes into the airway through the mouth. 
MOUTH-TO-NOSE is used where the casualty has sustained facial injuries that preclude using the mouth. The rescuer closes the casualty's mouth, seals the nose with his or her mouth, breathes gently, then releases the casualty's jaw to allow exhalation. 
MOUTH-TO-NOSE-AND-MOUTH is the preferred method when resuscitating a child, as the rescuer's mouth can cover and seal the child's nose and mouth. 
MOUTH-TO-STOMA is used for resuscitating a casualty fitted with a stoma from a pipe-like device fitted into the throat with an opening in the neck. These devices are often encountered because the casualty is in a high-risk group, usually because of previous respiratory and/or cardiac problems. The rescuer breathes through the stoma directly into the airway — a most effective method. 
MOUTH-TO-MASK is the most desirable method to be employed by the rescuer as a means of avoiding possible cross-infection. Masks come in various configurations, but their use is similar — the mask is fitted firmly over the casualty's nose and mouth, and the rescuer delivers breaths through the valve or aperture, thus avoiding direct contact with the casualty's mouth. 

 
 
When considering which resuscitation technique to use, the age of the casualty must be taken into account.  The classifications are:

-Infant - Newborn to 1 year 
-Young Child - 1 to 8 years 
-Older Child - 9 to 14 years 
-Adult - 15 years and older 

Additional consideration must be given to the physical size of the child.  Often a young child may be as well developed as an older child.

INDICATIONS FOR EAR:
unconscious collapse 
cyanosis (blue) 
absent respirations, or breathing rate less than 4—5 per minute 

PROCEDURE FOR EAR:
- check for DANGER 
- call help 
- roll casualty away from you 
- check airway 
- open airway 
- look, listen and feel for breathing 
- if breathing effectively, remain in stable side position 
  if not breathing, roll onto back 
- ensure airway is open (head tilt or jaw lift) 
- give two effective breaths - jaw support (pistol grip).  Make up to five attempts to achieve two  
  effective breaths 
- assess the rise and fall of the chest (if suspected obstruction — reassess airway) 
- check pulse 
 
IF PULSE PRESENT, commence EAR for adults and older children by giving one effective breath every 4 seconds (15 breaths per minute) for younger children and infants, give one effective breath every three (3) seconds (20 breaths per minute) reassess pulse about every one minute constantly reassess airway, be alert for vomitus 

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