Alternative methods of ventilation during respiratory and cardiac arrest.

Artificial ventilation is a cornerstone of basic life support-cardiopulmonary resuscitation (BLS-CPR). Recent data corroborate clinical studies performed in the 1950s and 1960s, suggesting a need to change the present American Heart Association standards for artificial ventilation. These studies show that gastric insufflation followed by regurgitation and pulmonary aspiration are a major hazard of artificial ventilation with an unprotected airway. Present BLS-CPR standards require that ventilation be performed rapidly between external chest compressions or with incremental breaths. These methods of ventilation predispose the victim to gastric insufflation. Alternative methods of ventilation with longer inspiratory time and thus lower flow rate and peak inspiratory pressure are suggested. Additionally, rescue personnel, particularly EMTs and paramedics, should be taught how to apply cricoid pressure to prevent gastric insufflation in victims with an unprotected airway.