Rescue breaths vs. Chest compression only CPR

CPR is a life saving skill that everyone should be able to perform.  There are many myths about how to actually perform CPR, the main one being do we use rescue breaths or not.  This is purely choice.

What are rescue breaths?

A rescue breath is used to manually put oxygen into the patients lungs when they are unable to on their own.  The action involves making a seal between the first aiders mouth and the patients mouth and blowing air into the lungs.

Normal atmospheric air contains approximately 21% oxygen when inhaled.  After gaseous exchange exhaled air contains around 17% oxygen, allowing oxygen to be passed on to the patient during rescue breaths.

Benefits of rescue breaths.

If the brain is deprived of oxygen for more than 3 minutes there is a good chance the patient will end with brain damage.  With this in mind rescue breaths can provide additional oxygen to the patient especially in children, those who have sustained asphyxial cardiac arrest or where there is a delay to the response of the Emergency Services.

Children go into arrests for very different reasons to adults.  Most Children suffer from respiratory arrest, which then causes cardiac arrest and therefore eliminating rescue breaths for children could in fact result in worse outcomes.

Benefits of compression only CPR.

Compression only CPR involves only using compressions and cutting out the rescue breaths.

As seen above we only use around 19% of the oxygen inhaled and 80% of oxygen is available in the exhalatory breath.  Therefore, there is more than enough residual oxygen in the lungs of the patient which is available to enter the blood, and therefore there is usually adequate amount of oxygen in the blood.

According to a study published by the journal of the American Medical Association, adults who experienced CRP out of a hospital environment are 60% more likely to survive if compression only CPR is used.  This is because it eliminates the compressions being interrupted by rescue breaths which can effect blood flow, as it is stated that the first 10 compressions used is to raise the blood pressure.

Guidelines.

There is no evidence to show that using rescue breaths provides any more benefits than chest compressions alone, or that chest compressions alone can cause more harm and therefore there is no change in the current guidelines.  If you are unqualified or unwilling to perform rescue breaths then chest compressions is enough.  However if the rescue breaths can be carried out quickly and effectively they should be carried out for the additional benefits, especially for children, those who have sustained asphyxial cardiac arrest or where there is a delay to the response of the Emergency Services, where oxygen volumes will be depleted.

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