CPR rules say skip mouth-to-mouth

The American Heart Association’s new bare-bones guidelines may get more people to lend a hand in an emergency situation.

The American Heart Association is suggesting a bare-bones approach to cardiopulmonary resuscitation that may get more people to step up and help.

When someone’s heart stops, when they collapse at the grocery store or the sideline of a soccer game — step one is still the same: Call for help.

Next, the guidelines say, provide hard and fast chest compressions. In the past, experts wanted us to first figure out if someone was breathing.

But Penn Medicine emergency medicine doctor Benjamin Abella says that approach was too complicated. Even health professionals sometimes struggle to determine if someone is breathing or not and lots of us are skittish about providing that first puff of air to a stranger.

Abella: The challenge was that people do not like the idea of touching someone’s mouth. They didn’t like the idea of doing mouth-to-mouth and happily the science has supported the fact that one doesn’t actually need to do it. And so this is one of these nice situations where the science and the public instinct merge nicely together.

Abella says the new approach reverses the old mnemonic. Instead of A, B, C for airway, breathing and circulation. It’s C, A, B – compressions, airway and breathing.

The idea is to do what’s most important first, keep blood moving throughout the body until professional help arrives.

Abella: Now there are some exceptions, for example, if someone drowns, or someone becomes unresponsive from an asthma attack. But these are very uncommon situations and more importantly in the drowning situation very often there are trained providers such as lifeguards — or other health-care professionals or related people — and they should still be trained in standard CPR.

The experts want to encourage laypeople to step and do something. They say it’s OK to skip the mouth-to-mouth and leave the rescue breathing to the professionals. The change comes on the heels of an article in the Journal of the American Medical Association. It shows that “hands only” CPR works effectively much of the time.