Is rescue breathing required for CPR?

Is rescue breathing required for CPR

Performing mouth-to-mouth resuscitation is needed in certain situations, let’s discuss which ones. Cardiopulmonary resuscitation is usually recognized as a combination of chest compressions and artificial ventilation. But is rescue breathing required for CPR? Some say it’s compulsory, while others state that rescue breathing is needed only in particular emergency cases.

Let’s look at what some credible institutions like the AHA (American Heart Society) and the American Red Cross have to say on this topic.

Rescue Mouth-to-Mouth Resuscitation: A Must-Know Part of The CPR Procedure

Even though the recommendations for the necessity of rescue breathing differ, this technique is a must-know part of the CPR procedure. Rescue breathing is a form of artificial mouth-to-mouth ventilation. The aim is to blow air into the person’s lungs and provide them with enough oxygen before the emergency personnel arrives.

Rescue breathing is done with the “head-tilt and chin-lift” maneuver and shutting the nostrils while giving mouth-to-mouth breaths. However, you should give rescue breathing differently for different age groups.

When treating an adult patient, two rescue breaths are usually given after every 30 chest compressions. On the other hand, when giving rescue breathing to a child or infant, the usual compression-ventilation ratio is 15:2 – two breaths for every fifteen compressions.

You should give rescue breathing in some of the following situations:

  • Drowning
  • Drug overdose or any kind of poisoning
  • Choking
  • Poisoning with carbon monoxide
  • Severe asthma attacks

Nonetheless, there’s also the compression-only CPR procedure. In the past few years, the AHA and the American Red Cross are recommending this procedure much more frequently.

Chest Compressions Come Before Mouth-to-Mouth Resuscitation

There are some situations when you can avoid rescue breathing. For example, according to the guidelines of the American Heart Association, there are two recommendations regarding mouth-to-mouth resuscitation.

First of all, if you don’t have any experience in giving CPR, you should give hands-only CPR. The reason behind this is that rescue breaths can be difficult if you don’t have previous experience. Furthermore, the patients don’t have time for your maneuvers and successive attempts to provide them with artificial oxygenation.

Secondly, in its guidelines, the AHA outlines the importance of chest compressions over rescue breathing. That’s why the previously known “ABC” (airway, breathing, compression) has been reformulated in “CAB” (compression, airway, breathing).

The logic behind this is that chest compressions mimic the heart’s blood pumping. This can maintain the level of oxygen and nutrients, which is very important for normal brain functioning. Mouth-to-mouth ventilation can interrupt the compressions and thus weaken the blood circulation within the body.

Some researches also support AHA’s statements. For instance, a 2017 study suggests that in most bystander CPR cases, only giving chest compressions was much more effective than a combination of chest compressions and artificial ventilation.

Situations When Mouth-to-Mouth Resuscitation Isn’t Recommended

Sudden cardiac arrest and lack of experience in performing CPR are the two main situations when rescue breathing isn’t recommended. Furthermore, AHA also points out the fear bystanders feel about mouth-to-mouth resuscitation and the increased risk of disease transmission.

If you’re still asking yourself, “Is rescue breathing required for CPR?” take a look at the following three situations.

Some Cases of Sudden Cardiac Arrest

In the case of a sudden cardiac arrest, experts advise that you don’t instantly start giving rescue breaths. Certain studies have found that in cases of sudden cardiac arrest, you should do compression-only CPR rather than full CPR.

When a person suffers cardiac arrest, uncirculated oxygen remains trapped in the bloodstream. Doing CPR without rescue breathing can be an effective way of circulating the remaining oxygen back into the bloodstream. On the other hand, interrupting the compressions with rescue breaths can only disrupt the blood pumping into the bloodstream.

However, this doesn’t mean that if you’re well trained in CPR and have experience, you shouldn’t give rescue breathing to someone in this situation. For example, the artificial breathing technique is necessary when you’re performing CPR on an infant who has gone into cardiac arrest. The reason for this is that babies usually have this because of airway blockage, choking, or severe allergic reactions.

Lack of Experience in Performing Mouth-to-Mouth Resuscitation

The American Heart Association recommends that people without CPR experience and bystanders don’t necessarily try to give rescue breaths. The artificial ventilation process is complex and can take a lot of time which is critical for the patient.

Moreover, hands-only CPR is much faster and easier than full CPR. Even if an inexperienced bystander performs it correctly, he can significantly increase the person’s chances of survival.

Increased Risk of Disease Transmission

Additionally, we must consider disease transmissions. Such an example would be the COVID-19 pandemic. Performing hands-only CPR can minimize the chances of transmitting viruses and other potentially harmful particles or bacteria.

Therefore after the burst of the COVID-19 pandemic, the AHA revised its guidelines on the standard CPR procedure. A reason plus is that emergency medical services (EMS) always have ventilation masks. Something which a regular bystander most probably won’t have with them in such an emergency.

So, in times of increased risk of disease transmission, people can do an equally effective CPR procedure without rescue breaths. This way, they’ll avoid the transmission of diseases while increasing the person’s chances of survival.

Situations When You Must Perform Mouth-to-Mouth Resuscitation

In practice, mouth-to-mouth resuscitation is necessary for almost all emergencies when CPR is needed. The most common situations when you should perform rescue breathing are:

  • A child or infant suffers cardiac arrest
  • Near drowning
  • Substance overdose
  • Severe asthma attack
  • Choking
  • Poisoning
  • Severe allergic reactions
  • Electrocution injuries

In all these situations, there’s a lack of oxygen circulation into the bloodstream. Moreover, with artificial ventilation, you’ll pump air into the person’s lungs and enough oxygen until the emergency personnel arrives.

Additionally, if you notice that the person suffers a secondary cardiac arrest, start the full CPR procedure immediately. Secondary cardiac arrests usually happen because there’s a breathing problem that prevents oxygen from entering the body. In this case, the rescue breaths will pump air into the person’s lungs and maintain the necessary oxygen level.

Nonetheless, before giving rescue breaths, ensure that the person isn’t breathing correctly. Sometimes after electrocution or poisoning, for example, a person may continue to breathe normally. In these cases, strictly avoid performing mouth-to-mouth resuscitation because you can disrupt the person’s normal breathing cycle.

The Importance of CPR Classes and Certificates for Mouth-to-Mouth Resuscitation

As we’ve already mentioned, AHA doesn’t recommend rescue breathing when performing layperson CPR. Additionally, it points out the similar effectiveness of hands-only CPR. That’s why there’re many guides on how to perform CPR without rescue breaths.

Furthermore, numerous institutions across the US offer CPR classes that are conducted online, in-person, or combined. By acquiring such a certificate, you’ll be able to immediately recognize the situation when rescue breathing is or isn’t required. What’s more, there are healthcare provider CPR classes that include rescue breathing simulation training.

Fully Understanding Mouth-to-Mouth Resuscitation

We’ve elaborated on all the situations when rescue breathing isn’t necessary. As we mentioned, in case of sudden cardiac arrest, when uncirculated oxygen remains in the bloodstream, you shouldn’t perform this method.

We’ve also noted the emergencies when mouth-to-mouth resuscitation is needed. Infant cardiac arrest, substance overdose, and choking are some situations when artificial ventilation is necessary.

It is easily assumed that emergencies, when rescue breaths are necessary, are much more frequent than situations when hands-only CPR should be done. However, before doing anything, try to assess the situation, call 911, understand the causes, and give the proper treatment. Furthermore, it’s always best to have a CPR certificate – it can help you assess the situation correctly and enable you to give proper care.