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?

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You could carry one of those little key-chain barriers. You've probably seen them. They literally go on your key-chain so that you have a barrier ready for an emergency anywhere.

Keep it in your pocket, even.

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Specializes in Emergency Department.

The chances of getting a communicable disease from doing CPR with mouth-mouth breaths is very low... that being said, definitely carry a barrier on your keychain. That way you always have one with you.

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Specializes in Emergency.

I go back and forth on this. I like to think in a time of crisis I would. Then I meet a random person throughout my day who looks like they haven't brushed their teeth in years. I suppose I could use my shirt as a barrier. Kinda like the "butt-gaskets" you use on public toilets. They don't really do anything for you but peace of mind, but peace of mind is half my battle.

So to answer your question, no you're not alone. Mostly.... :)

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Specializes in NICU, Post-partum.
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?

No, and this is what will make you a nurse far and above others.

Because you are willing to do what it takes to do to save someone's life. Not only would I do CPR without a barrier, but I wouldn't care if someone was bleeding everywhere, if I had to get my hands in the blood in a life-or-death emergency, then so be it. Yes, they could have HIV, etc...but the chances are extremely slim and I could not live with myself if I did not try.

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http://www.policeone.com/health-fitness/articles/3440667-Cop-dies-of-infection-after-CPR-with-baby/

Stories like this one are incredibly heartbreaking, and I would never risk my own life by doing CPR without a barrier. For that reason, I walk around with CPR masks and a barrier...I have an adult mask, infant mask and also just a cheap breathing barrier in the same bag that I wouldn't use b/c I have the masks with the one way valve.

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..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.

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I've read that a few studies have shown that providing ventilations and compressions has 'no added benefit' when compared with providing compressions only, except in babies and children, and drowning. This is for out of hospital CPR in the initial stages and I don't know if the evidence is actually there or not yet.

Like BabyLady, I would help someone who was bleeding to death (but if there were gloves anywhere near I wouldn't do it without them). If CPR was needed I'd probably do compressions only unless it was a baby or a child. I'd probably do compressions and ventilations if it was a drowning.

Plenty of people will have a different opinion and wouldn't consider doing ventilations without a barrier or putting their bare hands on a badly bleeding wound or whatever. This is a valid position to take, after all, these actions are not without risk and we're no use to our loved ones if we're sick or dead.

Tricky subject.

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Thank you for your perspectives everyone. Yes, I am aware of the keychain barriers. I have done a good bit of reading regarding all perspectives. I was just shocked that a room full of healthcare workers responded this way.

It seems I am not completely alone on AN.

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I always carry a barrier with me but my CPR instructor said that healthcare workers are supposed to still do breaths but not the general public. She also said that if some were worried about mouth to mouth then rip a small whole in a piece of cloth (shirt or whatever is available) and do breaths. I think I probably would do respirations but I don't know for sure since I have never been in that situation.

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I always carry a barrier with me but my CPR instructor said that healthcare workers are supposed to still do breaths but not the general public. She also said that if some were worried about mouth to mouth then rip a small whole in a piece of cloth (shirt or whatever is available) and do breaths. I think I probably would do respirations but I don't know for sure since I have never been in that situation.

A shirt is filled with holes, if they exhale or vomit, there is no protection. That's fine if people are willing to accept the risk, but healthcare workers do not have any increased responsibility to give mouth to mouth with no barrier.

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I thought of that myself when she said that but I guess she didn't think so. :rolleyes:

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