CPR: Just Chest Compressions, Mouth-to-Mouth Not Necessary

New Guidelines for CPR

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Care for patients is a combination of high tech and high touch and the American Heart Association is working hard to get the touch back into the equation. After years of advocating bystander CPR, cardiopulmonary pulmonary resuscitation, the "P" or pulmonary is being dropped and chest compressions may be enough.

Why the change? Because when many bystanders are confronted with a medical crisis, such as somebody collapsing with their heart stopping, they are too frightened to intervene. Often they are not certain whether they might even do harm. And with today's fear of getting an infection from an unknown person, doing mouth to mouth breathing on a stranger can add to that fear. The concept might be summarized by the axiom: if you can't do something well, don't do it at all.

But in a medical crisis, people who try to help make a difference and the result is patients survive. Studies have shown that bystanders who had no knowledge of CPR, were given simple instructions by 911 operators to do chest compressions and were able to save lives. It seems that there is often enough oxygen left in the blood stream to allow the brain and other organs to survive until medically trained personnel arrive, as long as that blood is circulated, and chest compressions does just that.

As usual, there are special situations where breathing for a victim is important, including babies and drowning victims, but the new recommendations make it easier for bystanders to make a difference.