To breath or not to breath: The ongoing debate

During the last couple of years, debate has been ongoing regarding the delivery of breaths during resuscitation efforts. Quite often it gets raised during my classes and it seemed timely to bring it up as a blog post.

Perhaps a little history is in order first. In the first half of 2006 improvements were introduced to the way CPR was trained and delivered. The ratio between compressions and breaths was standardised across age groups and numbers of rescuers. Overall the process was simplified to remove confusion and to increase the numbers of people prepared to attempt resuscitation. In December of 2010, the first two Rescue Breaths prior to compressions were removed and an extra step to remind people to ring for assistance was included.

The American Heart Association had made some recommendations about the removal of all Rescue Breaths which have been reported beyond the original intent of the recommendations.

On the Australian Resuscitation Council website FAQ page, this matter was raised for further clarification. It was emphasised that Compressions Only CPR was recommended for use by Emergency Medical Service dispatchers (911) in the United States of America when speaking with an untrained rescuer. I have been made aware that similar advice has been given by a 000 Call Taker to rescuers within the last few years. When queried with Ambulance dispatchers at the time, it was the practice to ensure compressions were given for the best possible effect of a casualty.

Recently, a colleague alerted me to the fact that at least one instructor had been teaching Compressions Only CPR instead of the ARC Guidelines. Apparently this may have become a wide-spread issue as the ARC issued a statement on October 8th 2012. It reminded all training organisations that full CPR must still be taught and assessed with Rescue Breaths and the use of protective breathing devices. The full statement can be read at http://www.resus.org.au/files/first-aid-training-organisations.pdf

“If a Statement of Attainment is to be issued, these skills must be taught, practised and assessed in accordance with the requirement of the relevant Unit of Competence.”