Normally, as part of Cardio-pulmonary Resuscitation (CPR) training on any first aid course, learners will be taught how to give good quality chest compressions AND effective rescue breaths. This is because when a person suffers cardiac arrest they will only have a limited amount of oxygen left in their body. This will run out as you circulate the blood with your chest compressions because the body uses up the oxygen.
Out of hospital cardiac arrest is one of the biggest killers in the UK. Cardiac arrest happens when the heart stops beating in a normal rhythm. This means it can’t pump blood (and vital oxygen) around the body properly.
For every minute wasted, a person’s chance of survival drops by 10%. To give the casualty the best chance of survival it is important they receive oxygen as well as chest compressions. Good chest compressions and effective rescue breaths buy the casualty time until help arrives. For this reason rescue breaths will still be taught on any first aid course. There are lots of inexpensive devices that you could use as a hygiene barrier, including resuscitation face shields and CPR pocket masks.
Of course you may be unwilling or unable to give rescue breaths. In these uncertain times we are all concerned about the spread of infection and the risk to our loved ones. It is understandable that any rescuer would be concerned about getting too close to a casualty, especially someone they didn’t know well. Remember any CPR is better than no CPR. If you can’t or won’t perform rescue breaths then chest compression only CPR (or ‘hands only CPR’) is better than nothing at all as you can still pump some of that residual oxygen around the body.
The Resuscitation Council UK are the body who set the standard for first aid practice. They currently recommend that as well as teaching normal first aid protocols, first aid trainers should also teach adaptations for Covid-19. These explain how you should respond in a real emergency if you have to treat a casualty who may have Covid-19. As many Covid positive people don’t show symptoms, it is safer to take precautions incase the casualty might be infected.
Personal protection equipment (PPE) should be available in every workplace for dealing with first aid emergencies. If you are a workplace first aider, you should familiarise yourself with this and know where to find it easily.
Current advice on how to perform resuscitation on an adult casualty:
- Avoid putting your face close to the casualty. Do not check for normal breathing by placing your ear or cheek near to the casualty’s mouth. Instead look for other signs of life. If the casualty doesn’t respond and you can’t confirm cardiac arrest, begin chest compressions anyway. Continue until help arrives.
- Call an ambulance – state clearly if you think the casualty might have Covid-19 symptoms.
- Place a cloth or towel over the casualty’s mouth and nose.
- Carry out chest compressions only. Push down hard and fast in the centre of the chest: 5-6cm at a rate of 100-120 compressions a minute. Keep going until professional help arrives.
- Use a defibrillator (AED) if there is one, as this does not increase any risk of infection. Switch on the device and follow the voice prompts.
- If there is PPE available, use it.
- After performing CPR, wash your hands thoroughly and seek advice from NHS Inform.
Current advice on how to perform paediatric resuscitation:
Ensuring an ambulance is on the way and taking immediate action is the most important thing you can do. Babies and children are ore likely to suffer cardiac arrest because of a respiratory problem than a cardiac problem. This means rescue breaths are even more crucial to their chances of survival.
There is an increased risk of Covid-19 transmission during rescue breathing. You will probably know the child or baby, so the risk of death from doing nothing probably outweighs any risk of infection to you. If the child’s parent/carer is present, you could talk them through the steps in CPR.
- Open the airway by tilting the head back and lifting the chin (this is very slight movement on a baby).
- Give 5 initial rescue breaths. Pinch their nose and seal your lips around their mouth. You might need to seal around the nose and mouth on a baby. Take a normal breath in and blow into their mouth. This should take about 1 second and is just a ‘puff’ on a baby. Watch the chest to check it rises. Attempt this 5 times.
- Push hard and fast on the chest 30 times. Keep to 100-120 compressions a minute at a depth of 4-5cm for a child and 3-4cm for a baby.
- Repeat a cycle of 2 rescue breaths and 30 compressions until help arrives.
- Provided the child is over 1 year you should use a defibrillator (AED) if there is one. Switch on the device and follow the voice prompts. If the device has a paediatric setting, use it.
Read the full guidance on CPR in the community here: