Rescue breathing is the delivery of air to a victim who is not breathing but still has a pulse, aiming to supply oxygen until professional help arrives. The correct rate balances the need for oxygenation with the risk of complications. Delivering breaths too quickly or with too much volume can lead to hyperventilation, increasing pressure in the chest and impeding blood return to the heart. Current resuscitation guidelines provide clear, evidence-based recommendations on ventilation rates to ensure effective support without causing negative side effects.
Standard Ventilation Rates for Adults
For an adult who has a pulse but is not breathing, the standard recommendation is to provide a single breath approximately every five to six seconds. This rate translates to about 10 to 12 rescue breaths administered per minute. This specific timing is designed to mimic a normal, slow respiratory rhythm, allowing the lungs to fully exhale between breaths. The goal is to maintain oxygen levels in the blood while preventing the buildup of carbon dioxide. Excessive ventilation is a major concern, as it can raise the pressure within the chest cavity. This increased pressure can compress the major veins that carry blood back to the heart, reducing the heart’s effectiveness. Adhering to the one-second-per-breath standard with a five-to-six-second interval optimizes gas exchange and protects circulation.
Specific Rates for Children and Infants
Pediatric patients, including children and infants, require a faster ventilation rate than adults due to different physiological needs. The recommended rate for a child or infant with a pulse but no normal breathing is one breath every three to five seconds. This equates to 12 to 20 rescue breaths per minute. Younger individuals have a higher metabolic rate and a greater oxygen demand compared to adults. Children are also more likely to suffer cardiac arrest due to respiratory failure rather than a primary heart problem, making ventilation a proportionally more important intervention. Providing a breath more frequently helps to meet this increased oxygen need and addresses the underlying respiratory issue.
Technique: Focusing on Breath Volume and Duration
Beyond the frequency of breaths, the quality of each individual breath is important for effective rescue breathing. Each breath should be delivered over approximately one second. The volume of air delivered should only be enough to cause the victim’s chest to visibly rise. This visible chest movement confirms that the air is successfully entering the lungs. Rescuers must avoid delivering breaths that are too forceful or too large in volume. Delivering excessive air can force air into the stomach, a complication known as gastric inflation. Gastric inflation can lead to regurgitation and aspiration, introducing foreign material into the lungs and causing further injury. Focusing solely on achieving visible chest rise ensures adequate oxygen delivery while minimizing risk.
Adjustments for Advanced Airway Support
In situations where advanced medical providers have placed a secured airway, such as an endotracheal tube, the ventilation rate changes significantly. With an advanced airway in place, chest compressions can be delivered continuously without pausing for breaths. This allows rescuers to maintain circulation with minimal interruption. The ventilation rate is fixed at one breath every six seconds, maintaining a rhythm of 10 breaths per minute, regardless of whether the patient is an adult, child, or infant. This asynchronous delivery ensures oxygenation is provided while prioritizing continuous, high-quality chest compressions to maximize blood flow. The secured airway allows for precise ventilation control, making the fixed rate an efficient standard for professional resuscitation teams.