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GUIDELINES 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care 2000 American Heart Association

Part 6: Advanced Cardiovascular Life Support
Section 3: Adjuncts for Oxygenation, Ventilation and Airway Control

(Edit Note: The © 2000 AHA Guidelines are Complimentary to the
1986 and 1992 AHA Guidelines on subject matters as excerpted below.)

Oxygenation Devices

  • During cardiopulmonary emergencies use supplemental oxygen as soon as it is available. Rescue breathing (ventilation using exhaled air) will ONLY deliver approximately 16% to 17% inspired oxygen concentration to the patient.
     
  • Tissue hypoxia leads to anaerobic metabolism and metabolic acidosis. Acid-base imbalance frequently blunts the effects of chemical and electrical therapy. For these reasons
    100% inspired oxygen (FiO2 = 1.0) is recommended during BLS and ACLS when available.
     
  • Short-term therapy with 100% oxygen is beneficial and not toxic.

Masks

  • Masks should be fitted with an oxygen (insufflation) inlet.
     
  • For mouth-to-mouth mask ventilation we recommend masks equipped with a 1-way valve that diverts the victim's exhaled gas. Mouth-to mouth ventilation has been shown to be superior to that with bag-mask devices and delivering adequate tidal volumes on manikins.
     
  • An adequate seal is best achieved with a mouth-to-mouth mask device when the rescuer is positioned at the top of the patient's head. The rescuer ventilates the victim by sealing his or her lips around the coupling adapter of the mask. Use both hands to hold the mask securely in position and maintain airway patency with head tilt.

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