b'ChapterComplications with Resuscitation Problems sometimes arise when ventilating a patient during rescue breathing. Air can enter the stomach if the rescuer over inflates or if the airway is not opened correctly. Air will accumulate in the stomach causing pressure to rise and force contents to be expelled (regurgitation).Regurgitation occurs in an unconscious patient because the muscle at the top of the stomach relaxes. This allows a passive flow of gastric contents from the stomach into the oesophagus, throat and mouth. This can very quickly lead to aspiration which is inhalation of foreign material into the lungs. Regurgitation is not normally accompanied by muscular spasm (like vomiting) thereby making it quite difficult for the first aider to detect. In a vomiting episode, stomach contents are generally forcefully ejected due to muscle spasm. This shows that the muscles are receiving oxygen and is a positive sign when resuscitating because the patient may start breathing on their own.In the event of regurgitation and vomiting, the patient must be quickly turned onto their side. The airway must be checked and cleared to prevent any stomach contents from entering the airways and lungs.How to minimise the risk of over breathing and regurgitation when rescue breathing:Make certain the airway is clear.Ensure the airway is opened wide using backward head tilt and chin lift. Gently ventilate the patient slowly so the lower chest and upper abdomen gradually rises. Ensure the chest completely falls between each ventilation.Be alert for any distension of the stomach and avoid any direct pressure over the stomacharea.Prepare to quickly turn the patient onto the side at any moment to protect the airway andlungs.Rib fractures occur and are common but acceptable consequences of CPR given the alternative is death. CPR should be initiated carefully for presumed cardiac arrest without concerns of further harm to a patient.50 Resuscitation'