Should You Deliver CPR Rescue Breaths?

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It is one of the questions that has spawned a lot of debate and research in recent years in the field of resuscitation science. We’ve blogged about it a couple of times including here and also here. Should you deliver rescue breaths as part of CPR? That is, should you deliver conventional CPR (compressions and breaths) or just ‘compression/chest only CPR’, continuous compression without breaths?

The European Resuscitation Council (ERC) released their lasted recommendations in their 2017 update. The ERC is a founding member of ILCOR (The International Liaison Committee on Resuscitation) and as such, is a highly regarded advisory body when it comes to the field of resuscitation. Within the update, ERC reviewed the range of latest research (clinical trials and observational studies) in the field of resuscitation science.

The ERC found that whilst the results of recent studies reviewed are mixed, there continues to be support that conventional CPR (compressions and breaths) is superior to ‘compression only CPR’, especially when it comes to patient outcomes. They also noted that conventional CPR with it’s breaths included, remains particularly important for certain patient groups including children and asphyxial cardiac arrests (e.g drowning, choking, toxic gases) and also where the arrival of paramedics is prolonged.

As a result of their research review, ERC continues to recommend conventional CPR over ‘compression only CPR’, with breaths recommended for those rescuers who are trained, able and willing to deliver them. This recommendation is also reinforced in Australia by the current ANZCOR guidelines, which recommends that “those who are trained and willing to give breaths do so for all persons who are unresponsive and not breathing normally.”

Now one major concern of rescuers delivering rescue breaths as part of CPR is the contraction of transmitted disease. As ANZCOR outlines in its guidelines, the risk of disease transmission during CPR is very low. A systematic review found no reports of
transmission of hepatitis B, hepatitis C, human immunodeficiency virus (HIV) or
cytomegalovirus during actual CPR. ANZCOR does however, always recommend the use of a barrier device, such as a face shield or CPR pocket mask, where available to minimise the risk of transmitted disease.

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