8. If you are _not_ getting air into the patient's lungs, or if he is not breathing out the air you blew into him, first make sure that his head is tilted back and his jaw is jutting out in the proper position. Then use your fingers to make sure nothing in his mouth or throat is obstructing the air passage to his lungs. If this does not help, turn him on his side and strike him sharply with the palm of your hand several times between his shoulder blades. This should dislodge any obstruction in the air passage. Then place him again on his back, with his head tilted back and his jaw jutting out, and resume blowing air into his mouth. If this doesn't work, try closing his mouth and blowing air through his nose into his lungs. 9. If you wish to avoid placing your mouth directly on the patient's face, you may hold a cloth (handkerchief, gauze or other porous material) over his mouth and breathe through the cloth. But don't waste precious time looking for a cloth if you don't have one. 10. _Important_: Even if the patient does not respond, continue your efforts for 1 hour or longer, or until you are completely sure he is dead. If possible, have this confirmed by at least one other person. TO STOP SERIOUS BLEEDING 1. Apply firm, even pressure to the wound with a dressing, clean cloth, or sanitary napkin. If you don't have any of these, use your bare hand until you can get something better. Remember, you must keep blood from running out of the patient's body. Loss of 1 or 2 quarts will seriously endanger his life. 2. Hold the dressing in place with your hand until you can bandage the dressing in place. In case of an arm or leg wound, make sure the bandage is not so tight as to cut off circulation; and raise the arm or leg above the level of the patient's heart. (But if the arm or leg appears broken, be sure to splint it first.) 3. Treat the patient for shock (see page 62). 4. If blood soaks through the dressing, do _not_ remove the dressing. Apply more dressings. 5. SPECIAL ADVICE ON TOURNIQUETS: Never use a tourniquet unless you cannot stop excessive, life-threatening bleeding by any other method. Using a tourniquet increases the chances that the arm or leg will have to be amputated later. If you are _forced_ to use a tourniquet to keep the patient from bleeding to death (for example, when a hand or foot has been accidentally cut off), follow these instructions carefully: --Place the tourniquet _as close to the wound as possible_, between the wound and the patient's heart. --After the tourniquet has been applied, do not permit it to be loosened (even temporarily, or even though the bleeding has stopped) by anyone except a physician, who can control the bleeding by other methods and replace the blood that the patient has lost. --Get a physician to treat the patient as soon as possible. PREVENTING AND TREATING SHOCK