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Discussion

Question about BLS cert. and CPR

So I just got my BLS certification yesterday. However, I have a question now that I didn't have yesterday. My class was not taught mouth-to-mouth CPR. The instructor never even touched basis on it. So, my question is, if ever given the scenario to do a mouth-to-mouth CPR, would I need to plug the victim's nostrils just like I see on TV and in the movies?

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What type of CPR were you taught?

I am wondering the same this? What did they teach you?

Hands Only CPR

This is a community CPR course. It was started because people refused to perform mouth to mouth on a stranger.

The "BLS for Healthcare Professionals" is the one that you should have taken. If yours doesn't say "Healthcare Provider" then the school will probably not accept it and you need to take the correct course.

Hands Only CPR This is a community CPR course. It was started because people refused to perform mouth to mouth on a stranger.

This is partially true, although people are not likely to do CPR due to concerns about communicable disease, hand only CPR is taught because the latest science favors uninterrupted chest compressions over frequently stopping compressions to ventilate.

  • Author

I did take the healthcare provider BLS course. We were taught with the masks/mouth-piece and bags.

Ambu bags should be at locations near the bedside or hallway outside patient rooms. You should never really need to put your mouth on a patient in any healthcare setting.

In a public setting, you can acquire and maintain a face shield that prevents some particle transmission.

  • Author

I'm really just looking for a yes or no answer: if ever given the scenario to do a mouth-to-mouth CPR, would I need to plug the victim's nostrils just like I see on TV and in the movies?

Cover their nose and mouth with yours if you can.

I'm really just looking for a yes or no answer: if ever given the scenario to do a mouth-to-mouth CPR, would I need to plug the victim's nostrils just like I see on TV and in the movies?

While the simple answer is "yes", the REAL answer you need to hear is "hell, no, you shouldn't be putting your mouth on ANYONE without knowing what the hell you are doing".

This includes mouth-to-mouth CPR. "Plugging the nostrils" does not teach you how to get a proper seal on someone's sloppy mouth, does it? Which is why someone taking a Community-Based CPR class will learn what they will need to know....and you did not. And the only human you are going to be able to cover both nose AND mouth, as previously suggested, is with an infant (and is only appropriate IN an infant).

One thought before I leave....I carry a very small pouch in my purse, that contains a plastic filmy mouth-cover/airway and pair of gloves to be used in CPR. I carry it in the event of needing to perform CPR without an ambu bag and feel I MUST do this (I will avoid placing my mouth on anything that's not food or family whenever possible). And yes, I had to learn how to place that plastic filmy thing correctly and get a proper seal so that resuscitation breathing would be effective.

Yes. Cover mouth. & nose with mouth is for infant & small child. If you don't pinch the nose when performing mouth to mouth the air will follow the path of least resistance and exit the nose rather than enter the lungs

That said EBP shows that if you are first on scene of an unresponsive adult call 911/activate EMS & send someone for the AED. If no face mask , oxygen or AMBU bag do effective compression only CPR until advanced help arrives. Effective compressions at 100/min is more beneficial than compressions + mouth to mouth and increased risk of disease transmission due to lack of barrier. Hence why mouth to mask & BVM ventilation are taught and not mouth to mouth ventilations

If you ever have to do rescue breathing and you don't have some kind of barrier device (I usually have one close by), try to get a good seal with your mouth over theirs. You can pinch their nose shut but if the person's face is small enough to get a good seal over both nose and mouth, do that. Only children and really small adults are the only ones that usually have faces small enough to allow a mouth-to-nose/mouth seal though. Just remember that you need to be absolutely certain their airway is open. If it's not, most of the air that you'll breathe into them ends up pressurizing the stomach. Eventually it'll let loose...

The incidence of disease transmission by this method that turns out to be incapacitative or fatal is extremely low to non-existent.

Yes. Cover mouth. & nose with mouth is for infant & small child. If you don't pinch the nose when performing mouth to mouth the air will follow the path of least resistance and exit the nose rather than enter the lungs

That said EBP shows that if you are first on scene of an unresponsive adult call 911/activate EMS & send someone for the AED. If no face mask , oxygen or AMBU bag do effective compression only CPR until advanced help arrives. Effective compressions at 100/min is more beneficial than compressions + mouth to mouth and increased risk of disease transmission due to lack of barrier. Hence why mouth to mask & BVM ventilation are taught and not mouth to mouth ventilations

It takes time to set up and use the barrier devices in one-person CPR. When you add in the fact that freshly dead people's blood doesn't desaturate very quickly, hands-only CPR is effective enough to buy time for a team to arrive to take over. When the team arrives, they'll usually dedicate one person to airway and another to doing CPR at a 30:2 ratio. If they are able to establish an advanced airway, they'll probably go to continuous compressions at 100/min and breaths ever 5-6 seconds, hopefully using ETCO2 to monitor compression effectiveness.

If you have to begin adding in ventilations to your CPR efforts, be very speedy in transitioning to and from providing ventilations because there's little to no circulation happening while you're not doing compressions and your first few compressions after you begin again won't be as effective at moving blood around as the ones you did right before you stopped compressions to do ventilation.

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