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CPR: Mouth-to-Mouth Not Much Help

Study: Chest Compression, Not Mouth-to-Mouth, Best Resuscitation for Adults

Death of Mouth-to-Mouth Resuscitation? continued...

Becker says the AHA has always said that if people feel uncomfortable doing mouth-to-mouth resuscitation, they should simply focus on chest compression. And he says the new study validates this approach.

Charles Sea, MD, an emergency-room physician at Ochsner Medical Center in New Orleans, teaches CPR to doctors. He says that new CPR techniques emphasize chest compressions over mouth-to-mouth ventilation.

"We are implementing new standards for faster, stronger chest compressions -- 100 a minute, and only about six to eight breaths a minute," Sea tells WebMD. "Compared to the old CPR, just doing compressions would get better results. But I bet if they did the new CPR with the fast compression and minimal ventilation, they would get even higher survival rates than with compression alone."

But mouth-to-mouth resuscitation steals precious time from chest compression, argues Gordon A. Ewy, MD. Ewy is director of the Sarver Heart Center and professor and chief of cardiology at the University of Arizona College of Medicine in Tucson.

"If you witness an adult collapse, it is most likely to be a cardiac arrest," Ewy says. "In cardiac arrest, the blood is fully oxygenated. What you need to do is press hard and fast on the chest to circulate the blood. This circulation you get from pushing on the chest is barely enough to keep the brain alive. If you stop for anything, like so-called 'rescue breathing,' which is an oxymoron, it is not good."

Reasons Remain for Mouth-to-Mouth

The main reason why the AHA teaches mouth-to-mouth resuscitation is that some people go into cardiac arrest because they have not been getting sufficient air. Such patients include drowning victims, for example, and victims of drug overdose. These patients do not have enough oxygen in their blood, and truly need mouth-to-mouth resuscitation.

But the vast majority of people who collapse have been breathing normally before their hearts stopped. That means that they have enough oxygen in their blood to survive until medical help arrives -- if someone gives them continuous chest compressions, Heidenreich says.

Heidenreich notes that chest compression is not risk-free.

"With the type of force it takes to move the blood through the veins, if you do good CPR you probably are going to break someone's ribs," he says. "In this past week, I've done CPR several times in elderly patients in the ER, and probably every time I have cracked a rib. But if you talk to most people -- and I have surveyed many -- most are much more concerned about contracting a disease from giving mouth-to-mouth than about breaking a rib to save a life."

Regardless of what kind of CPR you give, the most important thing is to call for help right away. CPR is intended only to keep a patient alive until emergency help gets there.

And the compression-only technique applies only to adult patients. Children are far more likely to have stopped breathing than to have suffered a sudden cardiac arrest. This means they far more often need mouth-to-mouth resuscitation than adults do.


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