Normally, breathing occurs through the mouth or nose, to the throat and from there through the windpipe into the lungs. When a person becomes limp, for example due to unconsciousness or lifelessness, the relaxed tongue muscle can fall back into the throat. This can completely block the airway. The airway must always be opened if the person does not wake up.

Lay the assisted person on their back

First, move the person in need of help onto their back on a hard surface, if possible. When the person is on their back, it is easier for you to open the airway and assess whether the breathing is normal or if there is an agonal breathing reflex (link). In the latter case, movement may be observed, but no airflow is felt, and it is a sign of cardiac arrest.

From the recovery position, it's also easy for you to turn the person into recovery position or begin CPR depending on whether they are breathing or not.

Lift the chin to check breathing

Opening the airway involves changing the position of the head of a person who is unresponsive. This is done to move the relaxed tongue muscle away from blocking the throat.

Do this:

• With one hand, press on the forehead of the person being assisted.
• Lift the person's chin with the other hand. As the chin rises, the limp tongue muscle stretches away from the throat.
• Check either with your hand or your cheek if you feel any airflow. Airflow usually feels like a gentle warmth against your skin.

If the person is breathing, this is a sign that their heart is also functioning. There is no need to check the pulse in this situation. Since breathing and heart function go hand in hand, the sensation of airflow, or breathing, is also an indication that the heart is working. Turn an unconscious but breathing person into the recovery position.

If the person is not breathing, this indicates that their heart is not functioning either. Again, there is no need to check for a pulse in this situation. Begin CPR immediately and instruct another person to fetch a defibrillator, an AED.