So..Rescue Breaths or No?

So..Rescue Breaths or No?

So..Rescue Breaths or No?

A lot of us know the ratio or 30:2, that is 30 compressions to 2 rescue breaths. But we’ve also heard that we ‘don’t have to give breaths anymore.’ 

So which is it?

Well, the answer isn’t cut and dry – it’s a decision that hopefully you’ll never have to make, but is up to you depending on the circumstances. 

In 2009, the American Heart Association released a paper that states:

“Laypersons should be encouraged to do compression-only CPR if they are unable or unwilling to provide rescue breaths, although the best method of CPR is compressions coordinated with ventilations.”

- AHA Science Advisory

UNABLE TO GIVE BREATHS

COMPETENCE

& CONFIDENCE

A big focus during our classes here at Hands Down CPR is on confidence and competence; giving Rescue Breaths is the epitome of this. It’s not just enough to know how to give rescue breaths (competence), you also have to believe you are able to follow through effectively (confidence).

In other words, if you know how to give breaths but freeze, you’re unable. Conversely if you want so badly to be able to give rescue breaths, but simply don’t know the skill, you’re also unable. 

Another reason is that you were never trained in the first place. Studies show that it’s ineffective to try to teach rescue breaths over the phone via a 911 operator. 

Here's the American Heart Associations recommendations on when NOT to give breaths:

If a bystander is not trained in CPR, then the bystander should provide hands-only CPR (Class IIa). The rescuer should continue hands-only CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over care of the victim.

- AHA Science Advisory

If the bystander was previously trained in CPR but is not confident in his or her ability to provide conventional CPR including high-quality chest compressions (ie, compressions of adequate rate and depth with minimal interruptions) with rescue breaths, then the bystander should give hands-only CPR (Class IIa). The rescuer should continue hands-only CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over the care of the victim.

- AHA Science Advisory

UNWILLING TO GIVE BREATHS

The second primary reason you wouldn’t give rescue breaths is because you’re simply unwilling. It’s common knowledge at this point that bloodborne pathogens (HIV, Hepatitis B, Hepatitis C) are transferable via bodily fluids – including the saliva of someone with open mouth sores or bleeding gums. That means, unless I have an extensive knowledge of a person’s medical history, there’s no way I’m giving breaths to someone I don’t know without a mask or a shield.

Also – folks are generally unwilling to put their mouth on a stranger in general, regardless of risk of disease. Having the option to omit rescue breaths from CPR increases the willingness of a bystander to help.

One of the very first lessons in BasicPlus | CPR, First Aid and AED for adults is about personal protective equipment. The lesson focuses on gloves, but using a mask during rescue breaths is just as important. 

NO MASK

NO BREATHS

YES TO BREATHS

SAY YES

TO BREATHS

Still – utilizing both high quality chest compressions AND rescue breaths will lead to the highest survival rate. 

Our recommendation: take your time in your next certification class to practice with the manikins. Perhaps you’ll consider getting certified annually to brush up on your skills more often.

Increase your confidence and competence to increase your life saving skills.

Here's the American Heart Associations recommendations on when TO give breaths:

If a bystander was previously trained in CPR and is confident in his or her ability to provide rescue breaths with minimal interruptions in chest compressions, then the bystander should provide either conventional CPR using a 30:2 compression-to-ventilation ratio (Class IIa) or handsonly CPR (Class IIa). The rescuer should continue CPR until an automated external defibrillator arrives and is ready for use or EMS providers take over care of the victim.

- AHA Science Advisory

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