I hear a version of that question before just about every CPR and AED class I teach. The answer is a bit yes and no… To be clear, for successful CPR course completion, rescue breaths with CPR is required.
Here are 2 things you need to know about rescue breaths with CPR:
What is compression-only CPR and why is it even a thing?
When an adult or adolescent has a sudden cardiac arrest (SCA), the person becomes unresponsive and stops breathing. The person’s body is still loaded with oxygen, it’s just that the heart has stopped beating and the oxygen is not being circulated.
‘Compression-only’ or ‘hands-only’ CPR is chest compressions without rescue breaths. It is a public service initiative for untrained rescuers to easily learn how to call 911 and then provide immediate chest compressions when they witness an SCA of an adult or adolescent.
Increasing bystander compression-only CPR rates should help increase survival of out-of-hospital SCA. Studies show that there is some air exchange with compression-only CPR. Besides, rescue breaths are tough enough for trained rescuers, let alone untrained.
If compression-only CPR works, why are rescue breaths required for CPR training?
Compression-only CPR does work, but only for a very specific type of cardiac arrest: Witnessed SCA of an adult or adolescent. Physiologically speaking, CPR with rescue breaths is better overall. In some circumstances, compression-only CPR is not recommended:
- Child and infant CPR: Most causes of pediatric cardiac arrest are related to respiratory failure, or more simply put, breathing stops first. Children, generally speaking, are healthy and don’t have cardiac issues. When a child or infant needs CPR it’s usually because of a severe breathing problem. Once a child or infant is in cardiac arrest, the oxygen level is already severely depleted, making rescue breaths with CPR very important.
- Respiratory failure leading to cardiac arrest: Drowning, overdose, choking, trauma, and sudden illnesses like severe allergic reaction and asthma attacks cause some cardiac arrests. In these cases the oxygen level is also severely depleted. Breaths are needed with chest compressions.
- Unwitnessed cardiac arrest: When cardiac arrest is unwitnessed, the person may have been down for a while. Like the circumstances above, the body is oxygen-depleted and the person will benefit more from CPR with rescue breaths than with compression-only CPR.
An Instructor's job is to teach traditional CPR, which includes rescue breaths. At the scene, the student becomes the rescuer and he or she will decide whether or not to give breaths. At the end of the day, students should understand that compressions without breaths is much better than doing nothing, but compressions with breaths give the best odds for survival (and are needed to get certified in CPR)!