A few years ago, the American Heart Association (AHA) recommended (based off of research) that rescue breathing may be disregarded by the layperson. The reasoning has turned out to be a basic need of citizens due to the absence of both chest compressions and rescue breaths. The layperson is the none healthcare provider who has nothing to do with treating patients medically on a regular basis. Simply stated, the healthcare provider is recommended to deliver rescue breaths for a person in cardiac arrest because they have the capability of using devices, i.e., Intubation Tube (ET), a Bag Valve Mask (BVM), or other Airway Assist Devices (AAD) and the layperson may have a pocket mask or nothing at all.
When the layperson encounters a person in cardiac arrest (no breathing and no heartbeat), he or she tends to walk away without providing CPR. The AHA does not hold these people liable, and neither does the law. The reason some of these laypersons decline to help is that they believe they must deliver mouth-to-mouth rescue breaths, and by doing so, the possibility of contracting a disease is a great fear. On the other hand, there are those who consider mouth-to-mouth rescue breaths as a procedure that is extremely nasty and distasteful. Thus, he and she walk away and do nothing but call 911, if that.
To accommodate for this lack of help, The AHA indicated that chest compressions, instead of rescue breaths could be done for a person in cardiac arrest. When the chest is compressed at least two inches (not exact but close enough) in the center of the chest by a rescuer and then relaxed, the flow of oxygenated blood is artificially pumped to the brain. Other organs receive this blood as well, but the number one mainframe is the brain. This activity allows for a better Return of Spontaneous Circulation (ROSC) when the chest compressions are repeated until advance Life Support (ALS) arrives.
When potential rescuers see a person in cardiac arrest, he or she can take appropriate and immediate action to restart the heart or maintain artificial circulation until ALS can get there. In fact, there are documented instances where bystanders (potential rescuers) provided only chest compressions and the victim recovered with ROSC to live a normal life. However, there are skeptics who argue that disregarding rescue breaths is detrimental to a victim’s survival from cardiac arrest. However, what is detrimental is doing absolutely nothing.
These arguments are always considered as medical advancement changes on a monthly and yearly basis. However, withholding rescue breaths is only a suggestion for laypersons. If the layperson decides to do rescue breathing, no argument is brought forward. Ultimately, when ALS arrives, the victim of cardiac arrest will receive rescue breathing with an insertion of an advanced airway. With that said, an explanation of the emphasis of rescue breathing is given.
When we sleep, we breathe, and when we talk, cough, eat or even swim, we breath. The reason we breath is because we have two lungs with three lobes that intake oxygen and other gases that are dispersed throughout our organs, especially our brain and heart. Without these gases, our organs will cease to function. Our brain will go into irreversible damage if declined of one of those gases called oxygen for 4-6 minutes. With each breath (depending on our age and health) we breathe in through our nose and sometimes mouth over 20,000 times. Consequently, we can’t help, but to breath, even if we hold our breath, our brain will send a signal to our lungs telling them to breathe so gas exchange will occur. Unfortunately, when the brain is in a clinical subconscious state due to cardiac arrest, those signals are not sent to the lungs. Hence, rescue breathing is indicated.
When the layperson declines to deliver rescue breaths, the way gas exchange occurs is through chest compressions with complete recoil. This is the way oxygen gets to the brain and other organs until ALS arrives. Even though rescue breaths are essential, the combination of chest compressions and rescue breaths produces the greatest survival rate. Therefore, the heart can not beat without the required gases needed, and the lungs can not deliver oxygen without the signal given from the brain. It is a continuous circle of life within an extremely complexed organic machinery that depends on each organ, brain, blood flow, and an outside entity called the layperson and ALS provider to keep it in motion towards a total recovery from cardiac arrest. Cardiac arrest is not desired by any form of life that is not in its latter end days of its lifespan, and it can be beaten with the proper use of life-saving measures of chest compressions and even rescue breaths which are needed but a suggestion for the layperson.