If someone were to suddenly collapse in front of you, would you know what to do? Many people hesitate in that critical moment, uncertain about the safest and most effective way to respond. Since the COVID-19 pandemic, concerns about health and safety have only grown, especially with increased awareness around infection risks and social distancing. As a result, both trained responders and everyday bystanders find it more challenging to perform mouth-to-mouth CPR during a medical emergency.
One of the most common questions people ask today is: Is mouth-to-mouth resuscitation still recommended in CPR? As CPR guidelines have evolved, the role of mouth-to-mouth has shifted. For many, this change brings hesitation—should you jump in, or wait? What is the safest way to help?
In this article, we’ll explore whether mouth-to-mouth is still part of CPR, why hands-only CPR has become more widely recommended, and when rescue breaths may still be necessary.
Is Mouth-To-Mouth Still Used in CPR?
No, mouth-to-mouth rescue breath is not recommended for untrained bystanders while performing CPR. The American Heart Association(AHA) recommends hands-only CPR without rescue breaths for adults who are experiencing sudden cardiac arrest.
After analyzing the involvement of bystander CPR and their attitudes toward mouth-to-mouth rescue breathing, the American Heart Association updated its CPR guidelines and decided to remove mouth-to-mouth rescue breathing from CPR in 2008.
Why Is Mouth-To-Mouth Not Recommended in CPR?
Rescue breathing was removed to encourage bystanders to be involved quickly in hands-only CPR during time-sensitive emergencies, which can save more lives. According to AHA, Hands-Only CPR is a public awareness campaign to encourage more people to be involved in CPR faster when they encounter someone having cardiac arrest.
There are several reasons why mouth-to-mouth rescue breathing is no longer recommended for most situations. The points below explain why Hands-Only CPR is now the preferred method:
1. Afraid of Making a Mistake During CPR
CPR with rescue breathing can be hard to do, especially for someone who hasn’t been trained. Many people are afraid they might do it wrong or hurt the person they’re trying to help. This fear often stops them from taking action. Hands-Only CPR is much simpler and helps people feel more confident to step in quickly during an emergency.
2. Unwillingness to help
Many people feel uncomfortable giving mouth-to-mouth rescue breaths to a stranger because it involves close contact with their mouth and possible exposure to saliva or other fluids. This discomfort can make someone unwilling to help at all. By removing the need for rescue breaths, Hands-Only CPR makes more people willing to step in and help, something that can make a big difference in saving a life.
3. Fear of Disease Transmission
Many people are reluctant to give mouth-to-mouth CPR because they fear they might catch a serious disease or other contagious illnesses. This fear of disease transmission can make bystanders hesitant to help, causing them to delay CPR or, in some cases, not perform it at all. The longer CPR is delayed, the lower the chances of survival for the person in need, which is why simplifying CPR to just chest compressions helps encourage more people to step in without hesitation.
4. Interrupts Life-Saving Chest Compressions
Giving rescue breaths during CPR interrupts the most important part of the process—chest compressions. In most cases of adult cardiac arrest, the blood still has enough oxygen, and the key goal is to keep it circulating to vital organs through continuous compressions. Stopping to give rescue breaths can slow down blood flow, especially in the crucial first few minutes of a cardiac emergency, making CPR less effective and reducing the chances of survival.
5. Effectiveness of Hands-Only CPR
Studies have shown that Hands-Only CPR, compared to traditional CPR, is just as effective, and in some cases even more effective, for adults who suffer from sudden cardiac arrest. This is especially true when people who haven’t been formally trained in CPR step in to help.
When is Mouth-to-Mouth Still Needed?
While chest compressions are the main part of CPR today, there are still some situations where mouth-to-mouth (rescue breathing) is important. These situations usually involve people who are not breathing, but their hearts might still be working.
Here are the times that indicate rescue breathing is needed:
1. Cardiac Arrest in Young Children
Young children often stop breathing because of choking, infections, or accidents. So, children need compression with rescue breaths to get enough oxygen because their cardiac arrest is often due to respiratory issues.
2. Drowning
When someone drowns, water fills their lungs, and they can’t get enough oxygen. Rescue breaths help get oxygen back into their body.
3. Drug Overdoses
People who overdose on drugs, especially opioids, may stop breathing. Chest compressions alone won’t give enough oxygen, so rescue breathing is important until medical intervention is available.
4. Choking
If someone chokes and loses consciousness, they can stop breathing. After clearing their airway, choking first aid with rescue breaths will help them get oxygen.
5. Collapse Due to a Breathing Problem
If a person collapses and isn’t breathing or is only gasping, giving rescue breaths can help keep oxygen in their body until help arrives. This is also necessary if someone with asthma or COPD stops breathing.
6. Carbon Monoxide Poisoning
Poisoning (like carbon monoxide) can cause breathing problems. Rescue breathing can help get oxygen to the body.
7. Prolonged Cardiac Arrest
Prolonged cardiac arrest increases the risk of severe brain and organ damage due to a lack of oxygen. In this case, rescue breathing becomes beneficial until medical help is available.
What Devices Can You Use While Providing Rescue Breathing?
If rescue breaths are necessary during CPR, it’s important to use barrier devices to lower the risk of transmitting germs for both you and the victim:
- CPR Face Shield or Mask: Use a CPR face shield or mask to create a barrier between you and the victim’s mouth and breath.
- AED Kits: Many portable AED kits, such as HeartStart or Defibtech Lifeline, include masks with one-way valves, allowing you to safely deliver rescue breaths.
- CPR Keychain Kits: These small, affordable kits with face shields are great to keep in first aid kits, gym bags, or workstations, ensuring you’re always prepared in an emergency.
Why Hands-Only CPR is the Best Response when You Can’t Perform Rescue Breaths?
Hands-only CPR is the best option when you can’t or don’t know how to give rescue breaths, especially in an emergency. Giving breaths the wrong way, too forcefully or too quickly, can push air into the stomach instead of the lungs. This can cause the person to vomit, and if they breathe in that vomit, it can lead to serious problems like lung infections. Additionally, mouth to mouth-to-mouth contact during CPR without barrier devices can have the risk of transmitting contagious diseases, and many people often feel hesitant to provide mouth-to-mouth CPR.
Many untrained people also don’t give effective breaths, which means little or no oxygen reaches the lungs. This wastes precious time and delays chest compressions, which are the most important part of CPR. Compressions help keep blood flowing to the brain and heart, and even a short delay can lower the person’s chance of survival.
Hands-only CPR avoids these problems. It’s simple and easy to remember: push hard and fast in the center of the chest, about 100–120 times a minute. You don’t need special training or to worry about opening the airway or giving breaths. This makes it easier for people to act quickly and confidently in a high-stress situation.
Hands-only CPR focuses on compression only and keeps the blood moving to vital organs. This steady blood flow is critical in the first few minutes after a person collapses. With more people trained in hands-only CPR and more public awareness, bystanders are more likely to help right away, and that quick action can save a life.
If you witness someone collapse, it’s important to act fast. Every second counts, and the steps you take in those first moments can be lifesaving. Here’s what you should do:
- Check the scene for safety – Make sure it’s safe for you to help.
- Tap and shout to check responsiveness – Gently tap the person and ask loudly, “Are you okay?”
- Call 911 immediately – If they’re unresponsive, call for emergency help right away or ask someone else to do it.
- Begin chest compressions – Start hands-only CPR by pushing hard and fast in the center of the chest.
- Use an AED if available – If there’s an Automated External Defibrillator nearby, turn it on and follow the voice instructions.
- Patiently wait for EMS – After helping, stay with the person and wait for Emergency Medical Services. When they arrive, tell them what you did and let them take over.
Hands-Only CPR: Make the Right Call
When someone suddenly collapses and stops breathing, what you do in the first few moments can help save their life. For most adults, the American Heart Association recommends Hands-Only CPR without mouth-to-mouth. Chest compression is easier to do, less scary for most people, and keeps blood moving to the brain and heart until help arrives. Still, mouth-to-mouth is important in some cases, like with babies, children, drowning victims, or people who stop breathing from an overdose or illness.
It is important to understand how and when to perform these life-saving techniques, and that’s where proper training comes in. Heart Start CPR is an AHA-approved training center that offers courses like BLS, ACLS, and PALS. Our experienced instructors guide you through real-life scenarios, using videos, pictures, and practical examples.
Join our BLS class today and be ready to save a life. We offer training in several locations, including Oakland, San Ramon, San Francisco, San Jose, San Leandro, Dublin, San Mateo, Walnut Creek, and Reno, Nevada. Don’t wait to become the person who makes a difference in someone’s critical moment.
