BLS Certification Manual: Ventilations for Adults

Ventilations for Adults

Ventilation provides oxygen when a person is not breathing adequately. The correct ventilation rate depends on whether the person has a pulse and whether an advanced airway is present.

Opening the Airway

For a person without suspected traumatic neck injury, use a head-tilt/chin-lift.

How to perform the head-tilt-chin-lift maneuver 

1. Place one hand on the forehead
2. Place the fingers of the other hand beneath the bony portion of the chin
3. Tilt the head back
4. Lift the chin

How Head-Tilt/Chin-Lift Works

Tilting the head back and lifting the chin moves the tongue away from the back of the throat, which is the most common cause of airway obstruction in an unresponsive person.

Suspected Head or Neck Trauma

A trained responder may use a jaw-thrust maneuver when cervical spine injury is suspected. If the jaw thrust does not adequately open the airway, use a head-tilt/chin-lift because maintaining oxygenation takes priority.

Adult With No Pulse

Without an advanced airway:

• Give 30 compressions followed by 2 breaths
• Give each breath over approximately 1 second
• Deliver only enough air for visible chest rise

Adult With a Pulse but Inadequate Breathing

Provide:

1 breath every 6 seconds, approximately 10 breaths per minute. Recheck the pulse approximately every 2 minutes. 

Advanced Airway

When an advanced airway is in place during CPR:

• Provide continuous chest compressions at 100-120 per minute
• Give 1 breath every 6 seconds
• Do not pause compressions for breaths

If the Chest Does Not Rise

Reposition the airway and improve the mask or mouth seal. Avoid repeated prolonged attempts that interrupt chest compressions.

Avoid Hyperventilation

Do not ventilate too rapidly or with excessive volume.

Special Note:  Exhaled air still contains approximately 17% oxygen, which is enough to help sustain the person receiving rescue breaths.