Performing rescue breathing during an emergency can sustain life until professional help arrives. A natural concern for many rescuers is the risk of contracting an illness from the person receiving care. This risk is inherent in procedures involving close physical contact, though the risk of pathogen transmission is typically low. Established protocols and specialized equipment exist to significantly minimize this danger, allowing bystanders to act confidently and safely.
Understanding the Infection Risk
The overall risk of a rescuer contracting a serious infectious disease during cardiopulmonary resuscitation (CPR) has historically been extremely low. Since the first medical use of mouth-to-mouth ventilation, only a small number of infection transmissions have been documented globally. This low rate is often attributed to the brief duration of the exposure.
Theoretical pathways for transmission include airborne droplets, contact with saliva, or exposure to blood or vomit. Pathogens causing common illnesses, such as the cold or flu, are statistically the most likely to be transmitted, rather than bloodborne viruses. The risk of contracting a severe bloodborne disease is only elevated if visible signs of blood or other bodily fluids are present in the victim’s mouth or nose.
Essential Barrier Devices and Proper Use
The most effective way to reduce the risk during rescue breathing is by utilizing a physical barrier device. These tools are specifically designed to create a shield between the rescuer and the patient, preventing direct contact with the mouth and nose. They should be kept readily available in personal first aid kits, car glove compartments, or attached to keychains for immediate access.
Two common types of barriers are the simple face shield and the more robust CPR pocket mask. A face shield is typically a flexible plastic sheet with a filter or a one-way valve positioned over the patient’s mouth. The pocket mask is a molded device that fits over both the mouth and nose, providing a superior seal and almost always featuring a one-way valve.
The one-way valve is the core protective element. It allows air to flow in a uni-directional manner from the rescuer to the patient. This mechanism prevents the patient’s exhaled air, fluids, or potential aerosols from traveling back toward the rescuer.
To use a pocket mask effectively, the rescuer must place the device over the victim’s face. Ensure the apex of the mask is over the bridge of the nose and the base is in the cleft of the chin.
The rescuer should use both hands to firmly press the mask edges down to create a tight seal against the face. A common technique involves placing the thumbs on the mask near the nose and the index and middle fingers along the jawline, simultaneously lifting the jaw to open the airway. By maintaining this seal and performing the head-tilt, chin-lift maneuver, the rescuer can deliver a breath through the valve, watching for the chest to rise.
Modifying Technique Compression-Only CPR
When a barrier device is not available, or a rescuer is unwilling or unable to provide mouth-to-mouth breaths, an alternative method is compression-only CPR, sometimes called Hands-Only CPR. This technique eliminates the infection risk associated with ventilation by focusing solely on chest compressions. The goal is to keep oxygenated blood circulating to the brain and other organs.
For an adult who suddenly collapses from a cardiac cause, the oxygen already in their bloodstream can sustain life for a short period if circulated vigorously. Hands-Only CPR involves pushing hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute.
Rescue breaths remain a preferred component of CPR in situations where the cause of cardiac arrest is likely due to a lack of oxygen. These scenarios commonly include drowning victims, individuals with an opioid overdose, or most children and infants. In these cases, providing breaths in addition to compressions offers a better chance of survival, and a barrier device should be used if possible. Any action, whether full CPR or compression-only CPR, is significantly better than doing nothing while waiting for emergency services.
Post-Procedure Safety and Hygiene
After the emergency situation has stabilized and the person has been transferred to professional care, immediate steps must be taken to ensure rescuer safety and hygiene. The barrier device used should be disposed of promptly and safely, as most are intended for single use to prevent cross-contamination. Any contaminated material should be placed in a sealed bag or biohazard container if available.
The rescuer must immediately wash their hands thoroughly with soap and water for at least 20 seconds. If soap and water are not accessible, an alcohol-based hand sanitizer with at least 60% alcohol should be used temporarily until proper washing can be done. This action removes any pathogens that may have transferred to the hands during the rescue.
If the rescuer came into contact with visible bodily fluids, such as blood or vomit, they should contact a healthcare professional or their local public health authority for guidance. Reporting the potential exposure allows medical experts to determine if any follow-up testing or prophylactic measures are necessary.