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Do We Still Give Breaths?

The British Heart Foundation has created a new video starring Vinnie Jones for the purpose of raising Hands-Only CPR awareness in the U.K

While some of the the terms used in the video may not apply to rescuers here ("geezer" may be slightly derogative, and what's a "sovereign"?), the concept is the same. Please remember that CPR Seattle is not liable for any injuries resulting from an inability to get the Bee Gees out of your mind.

Before starting a class at CPR Seattle, our instructors will often bring up the topic of recent changes in CPR protocol for the benefit of those who may have previously taken a CPR class. One question or comment that usually comes up goes something like "I heard you don't need to give breaths anymore" or "They took the breathing part out, right?"

The answer to that question is both yes and no. For the purposes of the CPR class they are about to take, it's usually no - all American Heart Association CPR classes that award a certification card still require delivering breaths as a part of the standard CPR protocols. While there are some medical professionals who have and continue to advocate against breaths as a necessary part of CPR (search for Dr. Gordon Ewy), the current international guidelines still recommend it. Anyone trained in a CPR certification class learns how to give breaths, and is encouraged to do so, if they are willing and able. In terms of importance, compressions is still the priority, but breathing is still considered a requirement. Note that this does not apply to children and infants, or when a collapse is not witnessed, i.e. the CPR is started some time after the collapse occurs. All these victims will realize greater benefit from a combination of breaths and compressions.

CPR without breaths, also referred to as "Hands-on" or "Hands-only" CPR, requires only chest compressions, given without pause until rescue personnel arrive on the scene.

This type of procedure is recommended for those without formal CPR class training, or for those cases where the rescuer is unwilling or unable to give effective breaths. For adult victims whose collapse is witnessed, and for whom emergency medical services respond quickly, this is an effective technique. Most adults in this situation experience heart failure before the breathing ceases, so they still have adequate blood oxygen to support brain function for as long as it takes for EMS to arrive. The continuous compressions keep this oxygen flowing to the brain.

A person who makes a 911 call at the scene of a collapse and does not know CPR may be instructed in this technique by an EMS dispatcher, as pushing on the victim's chest for a few minutes is not difficult for an untrained rescuer, unlike rescue breaths, which take practice to make effective and may not be something the rescuer feels confident performing.

All certifying CPR classes at CPR Seattle teach CPR with both rescue breathing and chest compressions. While the ratios for compression and breathing have changed over time, they are both still seen as an integral part of a rescue effort. However, given the urgency of CPR in these cases, compressions alone are always better than no CPR at all. Do what you can, as soon as you can, as well as you can.

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Published on January 10, 2012