Why is Mouth-to-Mouth No Longer Recommended?

CPR stands for cardiopulmonary resuscitation and is a life-saving maneuver used when an individual heart stops beating. CPR is when an individual pushes on the victim's chest to manually circulate blood throughout the body. Another technique is mouth-to-mouth resuscitation. This is where between every 30 compressions you provide two rescue breaths. 


Mouth-to-mouth resuscitation used to be a crucial step in CPR but as time has gone on recommendations have changed. Sparked by Covid-19, the general spread of germs has been a major concern for many civilians when faced with the task of CPR during a sudden cardiac emergency. It is now recommended to focus on effective and quality CPR to provide the best chance of survival. 


Why is Mouth-to-Mouth No Longer Recommended?


After many years of discussions, it is now recommended by the American heart association that untrained individuals should skip rescue breathing and perform hand-on-only CPR. Evidence shows that providing chest compressions is far more effective than doing nothing at all and new evidence is showing that stopping effective CPR to perform rescue breaths can cause more harm than good. Keeping the blood flowing throughout the body may be the most vital life-saving tool. The main reason individuals do not act or hesitate to provide CPR to individuals in need is their reluctance to want to provide direct contact with mouth-to-mouth resuscitation for the victim. Removing this step may be more effective in the long run but is also the key to removing the barrier of hesitation and getting as many individuals experiencing out-of-hospital emergencies the vital CPR they need to have a better chance of survival. 


  • Reduced Likelihood of Intervention from a Bystander
  • One of the main reasons individuals are hesitant or unlikely to give CPR to an individual in need is the fear of having to give mouth-to-mouth to a stranger. Discouraging CPR is the last thing a person experiencing a sudden cardiac arrest needs. Chest compression-only CPR can better increase the victim's chance of survival and even save a life. 


  • Interruption of Chest Compressions
  • Another reason mouth-to-mouth resuscitation is no longer recommended is the pause in chest compressions it creates. Precious time is being taken away from giving high-quality efficient CPR when worrying or trying to perform mouth-to-mouth resuscitation. Since most victims of sudden cardiac arrest are able to breathe prior to the emergency cardiac event there is a higher chance they have enough oxygen in the blood for chest compression CPR only until medical professionals arrive. 


    • Risk of Disease Transmission 

    When giving mouth-to-mouth resuscitation there is a possibility of disease transmission. With the Covid-19 pandemic, this was a major concern for most individuals. Emergency medical professionals carry equipment designed to handle these types of situations whereas untrained individuals do not, leaving them to either expose themselves or the victim to potential disease transmission. Hand-only CPR can be just as effective if not better for untrained individuals so it is important to provide continuous life-saving chest compression and avoid pausing.


    Is Mouth-to-Mouth Still Used in CPR?


    Mouth-to-mouth is still used in CPR (cardiopulmonary resuscitation) for specific emergency situations like drowning or choking. It is an important step, as it provides oxygen to the brain and other vital organs until medical help arrives. This technique involves providing rescue breaths by exhaling air into the victim’s mouth or nose, thereby forcing air into their lungs and restoring oxygenated blood flow. The use of mouth-to-mouth has been around for centuries, but due to public health concerns such as disease transmission, many people are reluctant to perform this life-saving procedure on strangers or even family members. To address this issue, the new CPR protocol calls for continuous hands-only CPR until medical professionals arrive. This removes any hesitation from the rescuer and gives the individual quality uninterrupted CPR.   


    What is Hands-Only CPR?


    Hand-only or compressions-only CPR is an emergency technique that can be used to help save the life of a person who has suffered cardiac arrest. It involves chest compressions, performed with both hands on the center of the victim's chest in order to circulate oxygen-rich blood throughout the body and keep them alive until medical professionals arrive. This type of CPR does not involve rescue breathing, which was previously thought to be a crucial part of resuscitation efforts. Performing chest compressions at a rate of 100–120 per minute helps maintain vital circulation, it is recommended to use a metronome or other device with audio cues for proper timing and rhythm during hands-only CPR. 


    How Does CPR Work & What Does CPR Do?


    When performing CPR, the goal is to manually pump blood through the body. Each chest compression creates pressure on the heart that helps it pump out blood. This increases circulation throughout the body and helps supply oxygen to vital organs like the brain so they do not become damaged from a lack of oxygen during cardiac arrest or another life-threatening event. 


    The rescuer should start by placing their hands in between each rib cage near where your sternum ends for proper placement when doing chest compressions. They should then press down firmly but gently about two inches deep at regular intervals (about 100–120 times per minute). CPR can be extremely effective if started soon after someone goes into cardiac arrest as it keeps blood circulating throughout the body until more advanced medical care can be administered such as defibrillation or medications which will restart their heartbeat back up again normally and safely without any damage being done internally due to lack of oxygenated blood flow within those few minutes before intervention was made available.


    What is the Indication for Mouth-to-Mouth Rescue Breaths?


    During sudden cardiac arrest, individuals typically breathe normally and receive oxygen before the emergency and become unresponsive. This leaves enough oxygen in their system for compressions during CPR. In some situations, the victims do not have enough oxygen circulating through the blood to keep the organs and cells safe and alive until further medical professionals arrive. During these situations, rescue breathing may help increase the individual's chance of survival. Mouth-to-mouth is recommended in some situations like 


    • Near drowning 
    • Drug overdose 
    • Poisoning
    • Choking 
    • Asthma attacks 
    • Young children 

    Infants and young children will most likely need rescue breathing due to the nature of their emergency typically beginning with a lack of oxygen. 


    Rescue Breathing for Adults


    If you do need to provide rescue breathing check the AED or first aid kit for a breathing mask, you can also keep one clipped to your keychain. This provides a barrier between you and the victim to lessen the spread of germs. To provide rescue breathing 


    1. Tilt the individual chin back to open the airway. 
    2. Pinch the victim's nose shut. 
    3. Place your mouth over the victims creating a seal. 
    4. Blow into the victim's mouth watching for the chest to rise.
    5. Provide 2 full exhales with a rising chest.
    6. Perform 30 chest compressions. 
    7. Repeat until the medical professional arrive on the scene 


    CPR stands for cardiopulmonary resuscitation and is a life-saving technique used when someone's heart stops beating. CPR involves pushing down on the chest at a rate of 100-120 times per minute and sometimes giving rescue breaths (mouth-to-mouth). This helps keep oxygen flowing to the brain and other organs. Hand-only CPR is when you only push on the chest and do not give rescue breaths. Mouth-to-mouth is still used in special cases like near drowning, drug overdose, poisoning, choking, asthma attacks, and for young children. Regardless of which type of CPR you give It is important to call 911 and get medical professionals on the scene as soon as possible.