Mouth to mouth without barrier?

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I will be beginning a BSN program in the fall. In preparation for school I was required to take CPR training. During the course of training the instructor mentioned the new compression first cpr (ccr) and stressed that no one is required to do mouth to mouth if they don't have a barrier (mask or other device) and that he wouldn' t. I understand that the point is to at least buy the individual a couple of more minutes - that at least getting compressions going is better than people not getting involved for fear of having to do mouth to mouth.

The instructor asked the class (13 people) to raise our hand if we would be willing to do mouth to mouth on an unknown person if a barrier device is not available. When the proposed patient was a 5 year old half the class said they would be willing. When the patient was a 55 year old I was the only one that stated I would be willing to do mouth to mouth without a barrier.

I understand the risks of disease transmission. I simply don't know that I could live myself if the person died (or worse) and I had chosen to do compressions only.

So my question to others is . . . am I alone?

If you were a licensed healthcare professional, you would not have a choice.

The law requires you to function, IF you choose to get involved, to your "highest level of training". The standard of CPR has changed for laypersons to chest compressions only, however, like the other poster said, rescue breaths are still required to be delivered by licensed professionals whether an abu-bag is available or not...barrier or not.

If you are a CPR instructor, I am very, very surprised you do not know that.

The fact that you live in a large city, is not going to help you in a court case from liablility when you become licensed.

Sorry, but you are misinformed. There is no law that requires healthcare providers, off the clock, without PPE to perform mouth to mouth, which would endanger the responder. The responder's safety is first, victim second.

(In addition, there are only four states with "Duty to Rescue" laws for nurses and they are Vermont, Wisconsin, Rhode Island and Minnesota. I have no idea what the details of those states' laws are, as I don't reside in any of them. I am assuming it is also Responder's Safety First in those states.)

Yes, you are misinformed. I was just re-certified with the AHA for Healthcare Providers. I took my class on March 25, just days before the new regulations came into effect. My CPR instructor a veteran RN with 35 + years experience was teaching the class and told us that even though we were so close to the change date wise, she had been informed to teach the "old way". After re-teaching the "old way" she then went on to explain the "new way" so we would know a little about it. Not at anytime did she say that as nurses, nurse aides, etc were we required to do mouth to mouth with the new way. You do have a choice as a healthcare provider.

That's funny, the class I took almost 2 years ago taught the new way (compressions only if you see victim go down). Maybe they knew it was coming and started teaching it then. No matter, it does make sense. If you are stopping compressions to do breathing (and the breathing is not 100% effective), then you are doing more harm than simply doing proper compressions.

And our instructor did not say we were obligated to do breaths as HCP.

Specializes in Emergency/Cath Lab.
..Also, compression only is not "worse" than risking your own life - you understand that without a bag valve mask you are mostly breathing carbon dioxide into the person, right? The compressions are enough to circulate oxygenated blood until paramedics arrive with a BVM if you don't have a barrier.

Ok this bothers me. Natural air we breathe is only 21% oxygen and upon exhalation it is still enriched at 16%. Even with a BVM, you have to have an oxygen source to get anywhere above that, otherwise you are still forcing 21% oxygen into the lungs.

That being said, I dont know what I would do. I typically have a barrier with me at most times. I have one in my car, my backpack and my trauma bag. And USUALLY one of those three is with me at most times. So a barrier is not far away to send someone to get. I've never had to do CPR outside of a hospital/EMS setting I hope I dont have to either.

Specializes in LDRP.
I will be beginning a BSN program in the fall. In preparation for school I was required to take CPR training. During the course of training the instructor mentioned the new compression first cpr (ccr) and stressed that no one is required to do mouth to mouth if they don't have a barrier (mask or other device) and that he wouldn' t. I understand that the point is to at least buy the individual a couple of more minutes - that at least getting compressions going is better than people not getting involved for fear of having to do mouth to mouth.

The instructor asked the class (13 people) to raise our hand if we would be willing to do mouth to mouth on an unknown person if a barrier device is not available. When the proposed patient was a 5 year old half the class said they would be willing. When the patient was a 55 year old I was the only one that stated I would be willing to do mouth to mouth without a barrier.

I understand the risks of disease transmission. I simply don't know that I could live myself if the person died (or worse) and I had chosen to do compressions only.

So my question to others is . . . am I alone?

what could possibly happen to the person thats worse than dying?

and.. if i didnt have a barrier i would probably do compressions only. i do not want some strangers possibly disease harboring vomit in or around my mouth.:uhoh3:

Specializes in Emergency/Cath Lab.
what could possibly happen to the person thats worse than dying?

and.. if i didnt have a barrier i would probably do compressions only. i do not want some strangers possibly disease harboring vomit in or around my mouth.:uhoh3:

There are far worse things in this world than dying....

I will be beginning a BSN program in the fall. In preparation for school I was required to take CPR training. During the course of training the instructor mentioned the new compression first cpr (ccr) and stressed that no one is required to do mouth to mouth if they don't have a barrier (mask or other device) and that he wouldn' t. I understand that the point is to at least buy the individual a couple of more minutes - that at least getting compressions going is better than people not getting involved for fear of having to do mouth to mouth.

The instructor asked the class (13 people) to raise our hand if we would be willing to do mouth to mouth on an unknown person if a barrier device is not available. When the proposed patient was a 5 year old half the class said they would be willing. When the patient was a 55 year old I was the only one that stated I would be willing to do mouth to mouth without a barrier.

I understand the risks of disease transmission. I simply don't know that I could live myself if the person died (or worse) and I had chosen to do compressions only.

So my question to others is . . . am I alone?

I can think of like two people on the Earth I would do mouth to mouth on. Otherwise, forget it. And no I wouldn't freak out and do it anyway out of panic.

Specializes in LDRP.
There are far worse things in this world than dying....

im saying, that can happen to the person you are doing cpr on as a result of giving them mouth to mouth vs compressions only. other than giving them a horrible disease, but then you should no better than to put you bare mouth on strangers if you have such a disease right?

Specializes in Emergency/Cath Lab.
im saying, that can happen to the person you are doing cpr on as a result of giving them mouth to mouth vs compressions only. other than giving them a horrible disease, but then you should no better than to put you bare mouth on strangers if you have such a disease right?

Ok good point. I see what you are saying now. And yeah, mouth full of some randoms vomit doesnt sound too good.

And now its time for dinner...

what could possibly happen to the person thats worse than dying?

and.. if i didnt have a barrier i would probably do compressions only. i do not want some strangers possibly disease harboring vomit in or around my mouth.:uhoh3:

To me being in a vegetative state is worse than dying. You're gone but your family doesn't get to heal and move on.

Specializes in Emergency Department.
..Also, compression only is not "worse" than risking your own life - you understand that without a bag valve mask you are mostly breathing carbon dioxide into the person, right? The compressions are enough to circulate oxygenated blood until paramedics arrive with a BVM if you don't have a barrier.

You are completely misinformed about the O2 percentage in expired air. There's a reason why rescue breathing works... "room air" is about 21% Oxygen. The air we breathe OUT when we exhale has approximately 16% Oxygen. Yes, the air does have a higher level of carbon dioxide than what's in "room air" but while someone's under CPR, the important gas is Oxygen, and CO2 won't affect anything significantly for a while. Additionally, most people out in public are very well oxygenated. It will take some time for the blood to desaturate enough to where compressions only CPR will no longer be effective.

Once you start CPR, minimize the amount of time that you're NOT doing compressions as that's the only thing that will actually move blood around.

Once the Paramedics arrive, don't be surprised if they begin doing continuous compressions and provide ventilation only about 6-8/min in between compressions after they've intubated the patient.

If you're doing good CPR, they may have you continue... otherwise expect the "thanks for the help, have a nice day..."

Specializes in Nasty sammiches and Dilaudid.

Other than blood family, there isn't anyone I'd do mouth-to-mouth on w/o a barrier.

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