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At least 19 recordsLinked to original sources
PubMed1985

Ventilatory volumes using mouth-to-mouth, mouth-to-mask, and bag-valve-mask techniques.

The volumes delivered to a resuscitation manikin were compared using four ventilatory techniques: mouth-to-mouth, mouth-to-mask, one-person bag-valve-mask, and two-person bag-valve-mask. The effects of experience and sex of the rescuer on the resuscitation volume delivered were also evaluated. The volume delivered using the one-person bag-valve-mask technique was significantly less than that using the other three techniques (P less than 0.001). The experience and sex of the rescuer made no significant difference in the volume delivered using any of the techniques. As compared with the one-person technique, bag-valve-mask ventilatory volume improved significantly when it was performed as a two-person technique. The mean volumes delivered using mouth-to-mouth and mouth-to-mask ventilation were lower than those recommended by the American Heart Association. Emphasis must be placed on ventilation with an adequate volume when these techniques are taught. When mouth-to-mouth and mouth-to-mask ventilation are taught, a spirometer should be used with the manikin so that the rescuer can learn how to estimate an adequate expired volume.

Allied Health Personnel↗
PubMed1986

[Motor activity of the mouth and mouth therapy in cerebral palsy. Preliminary results in the treatment of neuromuscular disorders of the mouth in children with cerebral palsy using the Castillo-Morales concept].

56 patients suffering from connatal cerebral palsy were treated with removable orthodontic appliances possessing stimulation areas according to Castillo-Morales. The intention was to improve the well-known orofacial dysfunctions of these patients. The evaluation of a standard treatment schedule leads to the following statements: The tongue and lip control can be improved in many patients, as well as the chewing and swallowing pattern, the speech and the problem of saliva running out of the mouth. The resting-position of the tongue is normalized in some of the cases. The habit of an open mouth can hardly ever be improved. In a small number of patients some parameters of orofacial function worsened during treatment; in most of these cases, however, a general improvement of orofacial function justified further treatment with palatal plates.

Cerebral Palsy↗
PubMed1997

Health care professionals' willingness to do mouth-to-mouth resuscitation.

To assess the willingness of physicians and nurses with training in basic cardiac life support to provide mouth-to-mouth resuscitation in both hospital and out-of-hospital settings, we surveyed all attendees at a monthly advanced life support course over a 1-year period. Of 622 attendees, 379 (61%) responded to our survey describing a variety of cardiac arrest scenarios. Less than half of the participants surveyed were willing to do mouth-to-mouth resuscitation on an unknown adult, male or female, who had collapsed in a supermarket. Overall, the group was willing to do mouth-to-mouth resuscitation on victims known to them: their neighbors (84%), children at a pool (88%), spouses (94%), and parents (93%). In the hospital setting, knowing a patient's human immunodeficiency virus (HIV) status greatly influenced the willingness to do mouth-to-mouth rescue. If a patient's HIV status was unknown, only a third of providers would do mouth-to-mouth resuscitation; if the HIV status was known to be negative, two thirds would do mouth-to-mouth resuscitation (P < 0.002), Children in the hospital whose HIV status was unknown would receive mouth-to-mouth resuscitation by 57% of the respondents. Children known to be HIV-negative would be resuscitated by 79% of the respondents. Co-workers were more willing to resuscitate a known physician or nurse than an unknown co-worker, with physicians more willing than nurses to do mouth-to-mouth resuscitation on an unknown co-worker. A third of the group has performed mouth-to-mouth resuscitation previously. Although an increased percentage of this subgroup was willing to provide mouth-to-mouth in all adult hospital scenarios, experienced providers of mouth-to-mouth wanted to receive mouth-to-mouth resuscitation less frequently (75%) than inexperienced providers (84%) (P = 0.02). The self-reported willingness to provide mouth-to-mouth resuscitation is influenced by patient characteristics; as the level of familiarity with the victim decreased, so did the willingness of the health care professional to do mouth-to-mouth.

Adult↗
PubMed2001

Prevalence of subjective dry mouth and burning mouth in hospitalized elderly patients and outpatients in relation to saliva, medication, and systemic diseases.

OBJECTIVE: The purpose of this study was to investigate the prevalence of self-reported symptoms of dry mouth and burning mouth in the frail elderly. We expected to find the studied symptoms more frequently in the frail elderly than in those who were healthier. STUDY DESIGN: We examined 175 home-living elderly patients (mean age with SD, 82 +/- 5.7 years) hospitalized because of sudden worsening of their general health. For comparison, 252 elderly outpatients (mean age with SD, 77 +/- 5.7 years) from the same community were studied. The subjects' medical diagnoses and prescribed drugs used daily were recorded, their oral health examined, and saliva samples taken for analyses of flow rates, yeasts, and a variety of biochemical factors. RESULTS: The results showed that 63% of the hospitalized patients and 57% of the outpatients complained of dry mouth. The respective percentages of burning mouth were 13% in the hospitalized and 18% in the outpatients. The dentate status affected the feeling of dry mouth and burning mouth, but there were no consequent differences in concentrations of salivary biochemical constituents, yeast counts, and buffering capacity between patients with or without the symptoms except that hospitalized patients complaining of dry mouth more often had low salivary buffering than those without the symptom. Dry mouth was also more prevalent among the hospitalized patients who used several drugs daily, whereas no such association was found with the burning-mouth symptom. Use of analgesics appeared to safeguard against both the symptoms. Dry mouth and burning mouth were seldom reported simultaneously, although low salivary flow rate was a common finding in patients with burning mouth. The strongest explanatory factors for burning mouth were psychiatric disease among the outpatients (OR 8.7, CI 1.4-54.1, P <.05) and use of psychiatric drugs among the hospitalized (OR 4.2, CI 0.9-20.0, P =.07). For dry mouth, the strongest explanatory factors were respiratory disease in the outpatients (OR 2.0, CI 1.0-3.8, P <.05) and low salivary flow rate in the hospitalized elderly (OR 3.7, CI 1.4-10, P <.05). In all patients (n = 427), use of psychiatric drugs was the strongest explanatory factor for dry mouth (OR 2.1, CI 1.2-3.5, P <.01), whereas analgesic medication was found to protect against burning mouth (OR 0.5, CI 0.3-0.9, P <.05). CONCLUSION: The subjective feelings of dry mouth and burning mouth appeared to be a complex issue among the elderly population studied. The 2 symptoms were seldom reported at the same time. The appearance of symptoms did not directly correlate with general health, except in the case of psychiatric diseases and medications, which should be taken into account.

Aged↗
PubMed2000

Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation.

BACKGROUND: Despite extensive training of citizens of Seattle in cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in almost half of witnessed cardiac arrests. Instructions in chest compression plus mouth-to-mouth ventilation given by dispatchers over the telephone can require 2.4 minutes. In experimental studies, chest compression alone is associated with survival rates similar to those with chest compression plus mouth-to-mouth ventilation. We conducted a randomized study to compare CPR by chest compression alone with CPR by chest compression plus mouth-to-mouth ventilation. METHODS: The setting of the trial was an urban, fire-department-based, emergency-medical-care system with central dispatching. In a randomized manner, telephone dispatchers gave bystanders at the scene of apparent cardiac arrest instructions in either chest compression alone or chest compression plus mouth-to-mouth ventilation. The primary end point was survival to hospital discharge. RESULTS: Data were analyzed for 241 patients randomly assigned to receive chest compression alone and 279 assigned to chest compression plus mouth-to-mouth ventilation. Complete instructions were delivered in 62 percent of episodes for the group receiving chest compression plus mouth-to-mouth ventilation and 81 percent of episodes for the group receiving chest compression alone (P=0.005). Instructions for compression required 1.4 minutes less to complete than instructions for compression plus mouth-to-mouth ventilation. Survival to hospital discharge was better among patients assigned to chest compression alone than among those assigned to chest compression plus mouth-to-mouth ventilation (14.6 percent vs. 10.4 percent), but the difference was not statistically significant (P=0.18). CONCLUSIONS: The outcome after CPR with chest compression alone is similar to that after chest compression with mouth-to-mouth ventilation, and chest compression alone may be the preferred approach for bystanders inexperienced in CPR.

Aged↗
PubMed2001

The effects of different mouth-to-mouth ventilation tidal volumes on gas exchange during simulated rescue breathing.

UNLABELLED: The American Heart Association recommends tidal volumes of 700 to 1000 mL during mouth-to-mouth ventilation, but smaller tidal volumes of 500 mL may be of advantage to decrease the likelihood of stomach inflation. Because mouth-to-mouth ventilation gas contains only 17% oxygen, but 4% carbon dioxide, it is unknown whether 500-mL tidal volumes given during rescue breathing may result in insufficient oxygenation and inadequate carbon dioxide elimination. In a university hospital research laboratory, 20 fully conscious volunteer health care professionals were randomly assigned to breathe tidal volumes of 500 or 1000 mL of mouth-to-mouth ventilation gas (17% oxygen, 4% carbon dioxide, 79% nitrogen), or room air control (21% oxygen, 79% nitrogen) for 5 min. Arterial blood gases were taken immediately before, and after breathing 5 min of the experimental gas composition. When comparing 500 versus 1000 mL of mouth-to-mouth ventilation tidal volumes with 500 mL of room air, 500 mL of mouth-to-mouth ventilation tidal volume resulted in significantly (P < 0.05) lower mean +/- SEM arterial oxygen partial pressure (70 +/- 1 versus 85 +/- 2 versus 92 +/- 3 mm Hg, respectively), and lower oxygen saturation (94 +/- 0.4 versus 97 +/- 0.2 versus 98 +/- 0.2%), but increased arterial carbon dioxide partial pressure (46 +/- 1 versus 40 +/- 1 versus 39 +/- 1 mm Hg, respectively). Sixteen of 20 volunteers had to be excluded from the experiment with 500 mL of mouth-to-mouth ventilation gas after about 3 min instead of after 5 minutes as planned because of severe nervousness, sweating, and air hunger. We conclude that during simulated mouth-to-mouth ventilation, only large (approximately 1000 mL), but not small (approximately 500 mL) tidal volumes were able to maintain both sufficient oxygenation and adequate carbon dioxide elimination. IMPLICATIONS: To provide efficient mouth-to-mouth ventilation, it is important to administer tidal volumes of 1000 mL; tidal volumes of 500 mL were not adequate.

Adult↗
PubMed1999

[Effects of mouth wash on the removing beclomethasone dipropionate delivered by pressurized aerosol metered-dose inhaler in the mouth].

Effects of mouth wash (mouth rinsing and gargling) on the removal of drug residues in both mouth and pharynx after the use of pressurized aerosol metered-dose inhaler (MDI) were studied. The concentration of beclomethasone dipropionate (BM) in mouth wash after a splay of Becotide inhaler was measured by the method using HPLC. The total amount of the removed BM was measured by a sum of the concentrations of BM in 4 or 5 times of mouth washes in the following 4 kinds of methods. In method 1, mouth wash was done with 5 times of water change after a splay of MDI on wetted mouth. In method 2, mouth wash was done with 5 times of change water on dried mouth. In method 3, mouth wash was done with 4 times of change saliva on wetted mouth. In these methods, the actual inhalation of BM was not done. In method 4, mouth wash was done with 5 times of change water after a splay and a inhalation on wetted mouth. The mouth wash procedures removed totally 47.9%, 51.1%, 31.3%, and 33.3% of a splayed amount of BM in each method, respectively. It was required for the removal of 90% of the totally recovered BM to do one time of mouth wash in method 1, two times in method 2, three times in method 3, and two times in method 4, respectively. These data suggest that the mouth wash procedure is shown to have prophylactic benefit for candidiasis induced by steroid delivered by MDI.

Administration, Inhalation↗
PubMed1997

From the foot-mouth reflex to the hand-mouth reflex. A continuum of responses to appendicular compression.

We studied the mouth opening response to appendicular compression in two groups of children. This study was performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p < 0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p < 0.01), and forearm in comparison to the proximal arm (p < 0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p < 0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.

Adolescent↗
PubMed2000

Role of mouth-to-mouth rescue breathing in bystander cardiopulmonary resuscitation for asphyxial cardiac arrest.

There is increasing evidence that mouth-to-mouth rescue breathing may not be necessary during brief periods of bystander cardiopulmonary resuscitation (CPR) for ventricular fibrillation. In contrast to ventricular fibrillation cardiac arrests, it has been assumed that rescue breathing is essential for treatment of asphyxial cardiac arrests because the cardiac arrests result from inadequate ventilation. This review explores the role of mouth-to-mouth rescue breathing during bystander CPR for asphyxial cardiac arrests. Clinical data suggest that survival from apparent asphyxial cardiac arrest can occur after CPR consisting of chest compressions alone, without rescue breathing. Two randomized, controlled swine investigations using models of bystander CPR for asphyxial cardiac arrest establish the following: a) that prompt initiation of bystander CPR is a crucially important intervention; and b) that chest compressions plus mouth-to-mouth rescue breathing is markedly superior to either technique alone. One of these studies further demonstrates that early in the asphyxial pulseless arrest process doing something (mouth-to-mouth rescue breathing or chest compressions) is better than doing nothing.

Animals↗
PubMed1994

The composition of gas given by mouth-to-mouth ventilation during CPR.

STUDY OBJECTIVE: To compare the concentration of a rescuer's exhaled O2 and CO2 during mouth-to-mouth ventilation with or without chest compression. DESIGN: Prospective repeated measures study. Simulated one- and two-rescuer cardiopulmonary resuscitation (CPR) was performed as recommended by the American Heart Association. SETTING: University laboratory. PARTICIPANTS: Fifty-five healthcare professionals certified in basic and advanced cardiac life support volunteered as rescuers in this study. MEASUREMENTS AND RESULTS: Thirty-three volunteers performed one-rescuer CPR, and 22 volunteers performed two-rescuer CPR. Minute ventilation for both groups increased 50% to 130% during CPR (p < 0.05). During the performance of CPR, the concentration of exhaled O2 increased from 16.4 +/- 0.7% to 16.9 +/- 0.5% in the one-rescuer CPR group and from 16.5 +/- 0.9% to 17.8 +/- 0.6% in the two-rescuer CPR group (p < 0.05). The concentration of exhaled CO2 in the one-rescuer CPR group did not change significantly throughout the entire experiment, but decreased in the two-rescuer CPR group from a baseline measurement of 4.0 +/- 0.6% to 3.5 +/- 0.4% (p < 0.05). During CPR, the concentration of exhaled CO2 was 4.0 +/- 0.4% in the one-rescuer CPR group compared with 3.5 +/- 0.4% in the two-rescuer CPR group (p < 0.05). CONCLUSIONS: The gas given by mouth-to-mouth ventilation is a hypercarbic and hypoxic mixture compared with room air. Mouth-to-mouth ventilation is the only circumstance in which a hypercarbic and hypoxic gas is given as therapy. Further laboratory and clinical studies are necessary to determine the effect of mouth-to-mouth ventilation during CPR.

Carbon Dioxide↗
PubMed2001

[Effect of mouth wash on the removing fluticasone propionate delivered by dry powder inhaler in mouth].

The effect of mouth wash on the removal of drug residues in both mouth and pharynx after the use of fluticasone propionate dry powder inhaler (FP-DPI) was studied. The concentration of FP in mouth wash after sprinkle and inhalation of Flutide 50, 100, 200 Rotadisk was determined by HPLC-UV. The total amount of the removed FP was measured by the sum of the concentration of FP in 5 times of mouth washes. The mouth wash procedures removed totally 79.3 +/- 4.4% (50 micrograms), 68.5 +/- 3.6% (100 micrograms), 69.3 +/- 3.4% (200 micrograms) of sprinkled amount of FP and 29.5 +/- 11.1% (50 micrograms), 35.6 +/- 6.6% (100 micrograms), 31.6 +/- 8.3% (200 micrograms) of inhaled, respectively. It was required for the removal of 90% of the totally recovered FP to do two times of mouth washes in each case. These data suggest that the mouth wash is an effective precaution for candidiasis induced by FP delivered by DPI.

Administration, Inhalation↗
PubMed1997

Clinical evaluation of the effect of a hydrogen peroxide mouth rinse, sodium bicarbonate dentifrice, and mouth moisturizer on oral health.

The objective of this 60-day single-blind, parallel trial, using 150 subjects, was to evaluate the effect of a 20% sodium bicarbonate dentifrice, a 1.5% hydrogen peroxide solution and a mouth moisturizer on oral tissues and microflora. Subjects were randomly assigned to one of five groups. The treatments were: 1) Sage dentifrice (sodium bicarbonate). Toothette Plus containing baking soda saturated with the hydrogen peroxide solution and use of a mouth moisturizer, 2) Crest dentifrice, Toothette Plus containing baking soda saturated with the hydrogen peroxide solution and use of a mouth moisturizer, 3) Crest dentifrice, Toothette Plus containing baking soda with a control solution and no mouth moisturizer, 4) Crest dentifrice, Toothette (without baking soda), saturated with a control solution and no mouth moisturizer, and 5) Crest dentifrice, Toothette saturated with 1.5% flavored H2O2 and no mouth moisturizer. From a subgroup of 35 patients (seven from each group) buccal smears for exfoliative cytology were taken as were supragingival microbiological samples from the mesial aspect of first molars (pooled). Buccal smears were evaluated for signs of histopathological changes. Microbiological samples from supra- and subgingival plaque for P. gingivalis, P. intermedia, A. actinomycetemcomitans. A viscosus, F. nucleatum, F. sanguis and C. albicans were evaluated. Clinical parameters measured were a stain index (SI), the modified gingival index (MGI), and a plaque index (PI). There were no adverse changes in the oral microflora and no anaplastic or other pathological changes in any subjects. Clinical parameters showed a statistically significant reduction in the MGI ranging from 26.7-29.9% with no significant differences among the groups (p > 0.05). The PI showed small reductions in all groups except group 2, but the differences were not statistically significant from each other or baseline (p > 0.05). The SI revealed slight increases in all groups and no differences among the groups. It can be concluded that use of Sage dentifrice, Toothette Plus saturated with Perox-A-Mint and Sage Mouth Moisturizer are safe to oral tissues. Using these components did not result in clinically noticeable stain formation, promote plaque formation, or produce any significant adverse changes in the oral microflora.

Adolescent↗
PubMed2001

Failure of mouth-to-mouth resuscitation in cases of sudden infant death.

We describe two cases of sudden infant death syndrome (SIDS) and one case of apparent life threatening apnoea where resuscitation was attempted by the mouth-to-mouth route. This was associated with evidence of gastric distension, including reflux of milk into the airway in the first two cases. In the second case the mother used mouth-to-mouth breathing after finding that she could not cover her baby's nose-and-open-mouth with her mouth. In the last case, the mother went on to try the mouth-to-nose route, with a good outcome. Systematic documentation of the route of resuscitation and its outcome in all cases of SIDS and near-miss SIDS may provide valuable insights into the optimal route for infant resuscitation.

Apnea↗