If the patient's chest is not inflating during the breathing task, you should check the patient's what?
Check the patient's AIRWAY. If the chest does not rise during rescue breaths, reopen the airway with a head-tilt/chin-lift, look for and clear any obstruction, and re-seal the mask before attempting the breath again.
The answer
If the chest is not inflating during a rescue breath, the first thing you check is the airway. A rising chest is the sign that air is reaching the lungs; when the chest does not rise, air is not getting in, and the most common reason is that the airway is blocked, poorly positioned, or the mask seal is leaking. The immediate corrective action taught in CPR and Basic Life Support (BLS) courses is to reposition the head to reopen the airway and try again.
The standard sequence when the chest fails to rise is:
- Reopen the airway using the head-tilt/chin-lift maneuver (or a jaw thrust if a spinal injury is suspected). The most frequent cause of a failed breath is that the head has slipped out of position and the tongue is blocking the airway.
- Check the mouth for an obstruction — visible vomit, blood, dislodged dentures, or a foreign object. Remove only what you can see; never perform a blind finger sweep.
- Re-seal the mask or reposition your mouth to eliminate air leaks around the seal.
- Attempt the breath again. Give the breath over about one second, just until you see the chest begin to rise — do not over-inflate.
Why the airway is the correct check
Rescue breathing has one measurable goal: get air into the lungs, confirmed by visible chest rise. If the chest is not moving, the air has to be going somewhere other than the lungs — either it is being blocked before it gets there (airway problem) or it is escaping around a bad mask seal. Both of these are airway-and-seal issues, which is why the airway is the correct and first thing to reassess. Checking a pulse, starting compressions, or fetching an AED does not fix a breath that will not go in; only reopening and clearing the airway does.
What to do if the airway is clear but the chest still won't rise
Current CPR guidance is that you should not interrupt care by making repeated attempts at a breath that will not go in. If your first breath does not cause the chest to rise, reposition the head and give a second attempt. If that breath also fails, treat the situation as an obstructed airway: return to chest compressions immediately. In an unresponsive person, the compressions themselves help dislodge an obstruction, and each time you open the airway to give breaths you should look inside the mouth and remove any object you can see before attempting ventilation again.
The bigger picture
In a full CPR cycle for an adult, you deliver 30 compressions followed by 2 rescue breaths, each breath given over about one second and only until the chest visibly rises. Effective breaths depend entirely on an open airway and a good seal, so troubleshooting a non-rising chest — reposition, inspect, re-seal, re-attempt — is a core BLS skill. Do not delay: if breaths still fail, high-quality compressions are the priority.
- 1
Chest not rising on the breath
Air is not reaching the lungs — treat this as an airway or seal problem.
- 2
Reopen the airway
- 3
Look inside the mouth
- 4
Re-seal and attempt again
- 5
Still not rising?
Frequently asked
Why is the chest not rising during rescue breaths?
The most common causes are an improperly positioned head that lets the tongue block the airway, a foreign-body obstruction, or a poor mask/mouth seal that lets air leak out. All three prevent air from reaching the lungs, so the chest does not rise.
How do you open a blocked airway?
Use the head-tilt/chin-lift maneuver to lift the tongue away from the back of the throat. If you see an object in the mouth, remove it, but never do a blind finger sweep. If a spinal injury is suspected, use a jaw thrust instead of tilting the head.
What is the head-tilt chin-lift maneuver?
Place one hand on the forehead and tilt the head back, then use two fingers of the other hand under the bony part of the chin to lift it upward. This straightens the airway and moves the tongue off the back of the throat so air can pass.
How many rescue breaths do you give in CPR?
For an adult, the standard cycle is 30 chest compressions followed by 2 rescue breaths. Each breath is delivered over about one second, just until you see the chest begin to rise — avoid over-inflating.
What do you do if the airway is clear but the chest still won't rise?
Reposition the head and give one more breath. If that second attempt also fails, do not keep trying — resume chest compressions immediately, and check the mouth for an obstruction each time you reopen the airway to give breaths.