First Aid/CPR Page
Science and CPR: What Changes Can We Expect in 2011?
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A summary of these recomendations follows: |
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Mouth-to-Mouth/-Nose Resuscitation: Classic Skills Making a Come Back?
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Important First Aid and CPR Demos, information, and Links
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Most lifeguards and first aid responders today may be too young to remember mout-to-mouth and mouth-to-nose resuscitation, but, once upon a time, the rescuer used to make a seal around the victim's mouth, nose, or mouth and nose, pinch the nose or close the mouth if not in the "seal," and blow. And lives were being saved.... Enter OSHA and the CDC. Enter Bloodborne Pathogens Training. Enter face shields, pocket masks, and bag-valve-mask resuscitators. Suddenly, an entire generation of rescuers has never practiced rescue breathing without a piece of plastic between the victim and the rescuer. Now, the new guidelines for CPR and emergency cardiac care are talking about mouth-to-mouth and mouth-to-nose breathing. For example: "Some health care providers and lay rescuers state that they may hesistate to give mouth-to-mouth rescue breathing and prefer to use a barrier device. the risk of disease transmission through mouth-to-mouth ventilation is very low, and it is reasopnable to initiate rescue breathing with or without a barrier device. When using a barrier device, the rescuer should not delay chest compressions while setting up the device." And: "Mouth-to-nose ventilation is recommended if ventilation through the victim's mouth is impossible (e.g., gthe mouth is seriously injured), the mouth cannot be opened, the victim is in the water, or a mouth-to-mouth seal is difficult to achieve. A case study suggests that mouth-to-nose ventilation in adults is feasible, safe, and effective." [bold added] It isn't clear whether these recommendations will make it into the textbooks currently being written to incorporate the 2010 guidelines, and certainly it is controversial to suggest that a lifeguard or other responder not protect himself/herself before making contact with the victim. But the only way this risk can be weighed against the hazards of a particular set of circumstances is to bring this out into the open, challenge existing protocols, and put new and beneficial skills into practice. In the middle of a submerged victim rescue, the lifeguard needs to understand that a few rescue breaths administered via mouth-to-nose resuscitation while en route to the deck or shoreline may revive the hypoxic victim or at least keep the victim's fading heart beating. If rescue breaths are not given en route, the victim may be clinically dead (i.e., no pulse) by the time the victim is removed from the water and a breathing barrier device is assembled and positioned for use. No one knows exactly when a victim will pass from nonbreathing-but-alive to clinically dead, but every second between initial contact for the rescue and initiating care is precious. Mouth-to-nose resuscitation in deep or shallow water represents a practical, low-risk technique that may help to ensure a more positive outcome with submerged, unresponsive victims. Additionally, in any situation involving hypoxia, a delay in giving rescue breaths due to the absence of a barrier device may not be justified when mouth-to-mouth and mouth-to-nose are viable alternatives to mouth-to-barrier ventilations. |
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