Revive CPR

To Breathe or Not to Breathe

When is rescue breathing necessary?

(Updated October 2023)

Medical Providers will always have airway devices readily available at work so they can safely administer breaths to a person who stops breathing, however when acting as a bystander everyone still has to stay safe: both medical professionals and lay-rescuers who are CPR certified.

The American Heart Association (AHA) emphasizes that mouth-to-mouth breathing is just for friends and family, so when you are using your CPR skills as a Bystander, Personal Protective Equipment (PPE) like a pocket mask with a one-way valve won’t become available until the AED arrives several minutes after a person stops breathing. How do you proceed without potentially exposing yourself to something scary. Fear of contracting COVID-19 is just one more possible deterrent from someone initiating CPR in public, along with hepatitis, influenza, Ebola, CCHF virus, Neisseria meningitidis, gastrointestinal pathogens (SalmonellaShigella),herpes, and many more. Although the risk is always there, many of these diseases would be most prevalent with hospitalized patients only.

Rescue breathing would be necessary in the following situations:

– Children and Infants

– Drowning victims

– Unresponsive choking victims

– Drug overdose

– Smoke inhalation

– Head injury that stops breathing

– An Unwitnessed Cardiac arrest

Note: Mouth-to-mouth breathing is intended for friends and family. Barrier devices should always be considered for people you don’t know. A “really” Good Samaritan would sometimes consider that the benefits of giving a person life-saving breaths far outweighs the risk.

Providing Hands OnlyTM CPR is the safest and most effective way to help save an Adult, but it is only effective for a Witnessed Sudden Cardiac Arrest (SCA). Please see our article on Hands OnlyTM CPR.

For me personally, if I am at the beach, or a pool and a person drown next to me I would give them mouth-to-mouth rescue breaths, since that could have been me lying there! Every person has a different level of comfort when it comes to giving life-saving breaths to a stranger. Getting vaccinated for Covid might alleviate some of your fear, however new variants may add more apprehension to giving breaths.

As a reward for coming to Revive CPR in San Francisco for your next CPR class, or BLS class we include a rescue keychain, mouth barrier device with every CPR certification we offer (a $10 value).

In medical settings, the Bag Valve Mask (BVM) is the safest and most efficient way to deliver breaths, but we certainly won’t have a BVM, or even a pocket mask when wearing a bathing suit at the beach, or pool. Unfortunately, the pocket mask or rescue keychain does not protect us from viruses.

For this reason Hands OnlyTM CPR could be utilized in all situations listed above as an alternative until EMTs arrive with a BVM.


Roy Gordon, EMT/ AHA CPR Instructor
Revive CPR Training San Francisco


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