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There is a long on-going discussion about the breathing part of CPR being so off-putting that it frightens people away from doing CPR altogether. I was wondering what can be done to make it less off-putting, assuming one does not have paramedic equipment to hand.

Obviously there is the miniature face mask, but most people do not bring that with them.

If the CPR is a two-person job, with the person pushing in charge, I could imagine telling the second person to clean the face with a tissue (assuming that starting with a delay is better than not starting) and then to breath through a second one.

I have never done CPR in a real life situation, so input from someone who has would be of particular interest.

Edit: Very sorry, I should have said that I was specifically not looking for "leave rescue breathing out" as an answer; I think that is a whole topic of its own.

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    As an aside to your question, as per this article, contrary to intuition, CPR without mouth to mouth (when performed by bystanders as opposed to trained professionals) may be just as good. hopkinsmedicine.org/news/media/releases/… – Kenshin Oct 8 '17 at 15:06
  • I did mouth to nose, or interposed a handkerchief at least pre aids days – Graham Chiu Oct 9 '17 at 7:05
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    I edited my answer but you're not leaving much to work with here. – Carey Gregory Oct 9 '17 at 20:35
  • Fair enough - thank you! (Accepted your answer.) – michaeljt Oct 10 '17 at 10:08
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That problem is already solved for you, at least in the US.

Current guidelines issued by the American Heart Association no longer require rescue breathing. Chest compressions alone are now the standard for community CPR (vs professional CPR). They refer to it as hands only CPR.

On an anecdotal note, I've done mouth-to-mouth on a perfect stranger. He was a young adult male drowning victim. It's not as off-putting as you might think. However, had he vomited, which is common in cardiac arrest, that would have made me wish for a pocket mask.

Edit in response to edit to the question:

If protective equipment like a pocket mask isn't available and omitting mouth-to-mouth isn't an option, then there aren't many options left. A piece of cloth used as a barrier might help reduce the gross factor, but I doubt it will do much to protect you from bacteria and viruses. If vomit is present, you need to clear the airway first anyway, which should have been covered in your CPR class. If blood is present, now you have to ask yourself how much risk you're willing to take since you could be exposing yourself to dangerous bloodborne pathogens. Although it's okay to wipe the mouth and face off with a wet cloth, it's not okay to try and rinse the mouth.

Honestly, should you find yourself in the situation of using your CPR training, I think you'll find that you'll be too busy and focused to even notice the off-putting aspects unless the patient is a real mess. Just do what needs to be done and what your risk assessment allows you to do. You'll probably be surprised how much work CPR is. Even professionals come away from a 'code' sweating.

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  • And afaik the law requires you to “help“. Or “help as good as you can“. Can you quote a law requiring cpr just “because you had a course“? – DonQuiKong Oct 8 '17 at 23:40
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    The German Red Cross Society still recommends rescue breaths, and mouth-to-mouth CPR is taught in first aid courses. However, if you fear that you’re endangering yourself, don’t do rescue breaths and resort to chest compression. Doing something is always better than doing nothing! – Narusan Oct 9 '17 at 8:09
  • France does the same as Germany. Guidelines basically say that mouth-to-mouth (or mouth-to-nose in certain cases) is still recommended (but in total obstruction cases of course), but should not be performed in case of risk (blood), fear or strong disgust. – Shlublu Oct 10 '17 at 14:22
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The British came across this exact problem. CPR was seen as a tricky business, especially when it was considered complicated and might involve mouth-to-mouth.

Their solution was (as Carey Gregory mentioned) to recommend chest-compressions in time to a relatively popular (and more importantly, catchy) song. Their logic was that even a simple step like that was much better than people standing about doing nothing out of fear of getting it wrong.

There was a big push to get this message out via an advert the British Heart Foundation ran with a famous actor (Vinnie Jones) in which he literally says the line: "No kissing, you only kiss your Mrs on the lips".

You can find it here: https://www.youtube.com/watch?v=hcQG2MMegXw or by searching "Vinnie Jones' hard and fast hands-only CPR".

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    The CPR song was 'Stayin' Alive' by the Bee Gees. Plenty of YOUtube videos showing Market Square demonstrations with scores of volunteers all doing CPR in time to the BeeGees. – Nigel J Oct 12 '17 at 3:06

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