Some instructors have decided not to teach mouth-to-mouth ventilation during resuscitation training.
The current Resuscitation Council (UK) guidelines include mouth-to-mouth ventilation during cardiopulmonary resuscitation (CPR) for both laypeople and healthcare professionals, but compression-only CPR is encouraged for those who are untrained, unable or unwilling to perform mouth-to-mouth ventilation. Compression-only CPR is better than no CPR, and this is the primary message in high-profile media campaigns in the UK that target people who have not been trained in CPR.
Resuscitation Council (UK) Guidelines 2010 for Basic Life Support state that studies have shown that compression-only CPR may be as effective as combined ventilation and compression in the first few minutes after non-asphyxial arrest. However, chest compression combined with rescue breaths is the method of choice for CPR by trained lay-rescuers and professionals and should be the basis for lay-rescuer education.
Compression-only CPR has potential advantages over chest compression and ventilation, particularly when the rescuer is an untrained or partially-trained layperson. However, there are situations where combining chest compressions with ventilation is better, for example in children, in asphyxial arrests, and in prolonged resuscitation attempts. Therefore, CPR should remain standard care for healthcare professionals and the preferred target for laypeople, the emphasis always being on minimal interruption in chest compressions. A simple, education-based approach is recommended:Ideally, full CPR skills should be taught to all citizens.Initial or limited-time training should always include chest compression.Subsequent training (which may follow immediately or at a later date) should include ventilation as well as chest compression.
CPR training for citizens should be promoted, but untrained laypeople should be encouraged to give chest compressions only, when appropriate with telephone advice from an ambulance dispatcher.
Those laypeople with a duty of care, such as first-aid workers, lifeguards, and childminders, should be taught chest compression and ventilation.
Resuscitation Council (UK) Guidelines 2010 for In-hospital resuscitation state that if there is no airway and ventilation equipment available, giving mouth-to-mouth ventilation should be considered. If there are clinical reasons to avoid mouth-to-mouth contact, or you are unwilling or unable to do this, do chest compressions until help or airway equipment arrives. A pocket mask or bag-mask device should be available rapidly in all clinical areas.
Current guidelines recommend starting CPR with chest compressions and this helps avoid the need for mouth-to-mouth resuscitation in most clinical situations as airway equipment should be available rapidly. The Resuscitation Council (UK) recognises that there will be circumstances where mouth-to-mouth ventilation is not appropriate. But there are occasions when giving mouth-to-mouth ventilation could be life-saving.
Mouth-to-mouth ventilation is an important resuscitation skill that is relatively easy to teach and learn, and should be included in resuscitation training for healthcare professionals.