Despite the recent approval of the hands-only technique, mouth to mouth is still a crucial element of CPR
The American Heart Association (AHA) recently revised their CPR guidelines to de-emphasize mouth-to-mouth resuscitation. While there are studies backing this decision, it doesn’t mean the technique is no longer recommended.
In general, CPR is the combination of two techniques: rescue breathing (mouth-to-mouth) and chest compressions. Hygienic and other concerns regarding mouth-to-mouth make performing it an obstacle for those not properly trained in CPR. This reluctance, unfortunately, can come at the expense of saving lives.
Something is often enough – and always better than nothing
Incorporating mouth-to-mouth with chest compressions can be difficult even for trained paramedics. For untrained bystanders, the demand can be prohibitive. Regardless of the reason behind not performing mouth-to-mouth, viewing it as a requirement is thought to prevent bystanders from helping at all.
A study led by Dr. Ken Nagao at Tokyo’s Surugadai Nihon University Hospital examined the implications of this failure to respond. Cardiac arrest victims on whom no CPR was applied (approximately 70% of 4,068 incidents) were not only far less likely to survive, their chances of suffering brain damage from the incident increased if they did pull through.
18% of the victims in the study received traditional CPR that included mouth-to-mouth. Those patients saw an improved survival and recovery rate. 11% of those in the study had the chest-compression-only technique applied – and they were 2.2 times less likely to experience brain damage than those who didn’t receive any CPR at all.
Aside from the reluctance to perform rescue breathing, compressions are often all that is necessary – in certain situations. In these cases, the body already has enough oxygen to survive until emergency services arrive, but only if chest compressions are administered.
Infant victims, drownings, and other scenarios in which mouth-to-mouth is still required
The new guidelines are definitely not a one-size-fits-all approach. When cardiac arrest is caused by asphyxiation – a lack of respiration – mouth-to-mouth can be the difference between life and death.
The following are examples of when compression-only CPR is not recommended:
- Children and infants. In a majority of pediatric cardiac arrests, breathing ceases before the heart stops beating. In other words, asphyxiation causes cardiac arrest, rather than the other way around. Respiratory problems are the most likely cause of cardiac arrest in children and infants –unlike adults, for whom heart problems are typically the cause.
- Upon discovering a cardiac arrest victim. When someone encounters a person already in cardiac arrest, there’s no way of knowing how long it’s been since their breathing stopped. The body is likely to already be starved of oxygen, therefore, including mouth-to-mouth may improve the chances for resuscitation and recovery.
- Non-cardiac arrest respiratory failure. Drownings, allergic reactions, asthma attacks, choking – if the heart stops due to a respiratory event, mouth-to-mouth combined with chest compressions can help maintain oxygen levels in the victim’s body.
Training and practice save lives
As those trained in CPR know: the first step is calling for help. After that, it’s time for training to kick in. American Heart Association CPR and AED (automated electronic defibrillator) instruction teach you how and when to perform CPR based on the condition of the patient.
One Beat CPR+AED offers AHA certified CPR and AED courses to South Florida businesses, schools, medical professionals, families, and individuals. To learn more about what’s involved in our AHA–certified classes, we encourage you to read our blog, “CPR Training Demystified”.