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.