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CPR providers should give rescue breaths with an inflation duration of about 1 second and provide sufficient volume to make the victim’s chest rise. Breath gently and steadily, avoid rapid or forceful breaths. The maximum time taken between compressions to provide the two breaths should not exceed 10 seconds.
If the breath does not go in, check for obstructions in the mouth, but do not do blind finger sweeps. Re-open the airway and try again but only try the recommend number of times. For example, do not try six times to get the two breaths in.
We can deliver the breaths via the mouth but also in other ways.
Mouth-to-nose ventilation is an acceptable alternative to mouth-to-mouth ventilation. It may be considered if the victim’s mouth is seriously injured or cannot be opened, the CPR provider is assisting a victim in the water, or a mouth-to-mouth seal is difficult to achieve.
Mouth-to-tracheostomy ventilation may be used for a victim with a tracheostomy tube or tracheal stoma who requires rescue breathing.
Barrier devices decrease transmission of bacteria during rescue breathing in controlled laboratory settings. Their effectiveness in clinical practice is unknown.
The Resuscitation Council has carefully considered the balance between potential benefit and harm from compressions-only CPR compared to standard CPR that includes breaths. As a result they have recommended that individuals who have been trained to deliver CPR should wherever possible perform rescue breaths and compressions as this may provide additional benefit to the patient, particularly for children and for those who sustain an asphyxial cardiac arrest, for example, drowning and also where EMS could be delayed. Only if rescuers are unable to give rescue breaths should they do compression-only CPR.
The latest CPR guidelines are the 2015 UK and European Resusciation Council guidelines. The next scheduled update will not be until October 2020.