Cardiopulmonary resuscitation (CPR) is an emergency procedure performed when someone’s heart stops beating or they stop breathing, often due to a heart attack or near-drowning. This intervention helps maintain blood flow to the brain and other organs, increasing survival chances until professional medical help arrives. A common question involves the necessity of mouth-to-mouth resuscitation, also known as rescue breaths, during CPR. This article clarifies when rescue breaths are indicated and when chest compressions alone are sufficient.
Understanding Rescue Breaths
Rescue breaths are a component of traditional CPR, delivering oxygen to an unresponsive person not breathing normally. Historically, CPR training emphasized “ABC” (Airway, Breathing, Circulation), prioritizing airway opening and breaths before chest compressions. This supplies oxygen to the victim’s lungs, which subsequent chest compressions then circulate throughout the body, especially to the brain and other organs.
Each rescue breath involves tilting the head, lifting the chin, pinching the nose, and sealing your mouth over theirs to blow air in for about one second, observing for chest rise. This ensures oxygen reaches the bloodstream to sustain tissues, especially the brain, which can suffer damage within minutes without oxygen. While room air contains approximately 21% oxygen, exhaled air still contains between 16% and 17% oxygen, which is enough to support life during resuscitation.
When Hands-Only CPR is Effective
For adults and adolescents who suddenly collapse from cardiac arrest, hands-only CPR (continuous chest compressions without rescue breaths) is often recommended. This approach is effective because, in sudden cardiac arrest, individuals usually have enough oxygen in their blood for the first few minutes. The problem is lack of blood flow to circulate this oxygen to the brain and other organs.
Continuous, forceful chest compressions (100-120 per minute, 2-2.4 inches deep) effectively pump residual oxygenated blood. Studies indicate hands-only CPR can be as effective as traditional CPR with breaths for adult cardiac arrest victims when initiated within the first 3 to 5 minutes. This simplified method can also increase bystander willingness to act, leading to more people receiving immediate aid.
Scenarios Requiring Rescue Breaths
While hands-only CPR suits many adult sudden cardiac arrest cases, rescue breaths remain important in specific situations. These scenarios involve an initial lack of oxygen, making immediate breaths alongside compressions particularly beneficial. For instance, CPR for infants and children universally requires rescue breaths because cardiac arrest in these age groups is often caused by respiratory issues or asphyxia, not a primary heart problem.
Drowning incidents are another scenario where rescue breaths are recommended, often as the first step before compressions. When someone drowns, their lungs fill with fluid, leading to a severe lack of oxygen, making immediate oxygen delivery through breaths important. Similarly, drug overdose, suffocation, choking, or any situation where breathing stops before the heart (respiratory arrest) also necessitate rescue breaths. In these instances, the body’s oxygen levels are severely depleted, and providing breaths helps re-oxygenate the blood for effective circulation by compressions.