CPR Experience: A Lifesaver or a Risky Practice?

In my early days as an Emergency Medical Technician (EMT), the practice of performing mouth-to-mouth resuscitation (CPR) was quite common. However, my experiences as an EMT have given me a unique perspective on the risks involved and the effectiveness of certain techniques under pressure.

From the 1970s: Mouth-to-Mouth Resuscitation

Back in 1978, when I was just a young EMT, performing mouth-to-mouth resuscitation was a widely practiced procedure. At that time, it was seen as a perfectly acceptable and effective method to revive a patient whose breathing had stopped.

A Personal Experience: Vomiting Patients

One of the most memorable experiences during my early career involved performing mouth-to-mouth resuscitation three times. Each time, the patient vomited into my mouth. This experience was particularly distressing and led me to reconsider the method.

The Psychological Impact

The act of someone vomiting into your mouth during a resuscitation attempt is deeply unsettling. The combination of fear, discomfort, and the awareness that the patient is fighting for their life creates a high-pressure situation that can affect even the most seasoned professional.

The Evolution of CPR Techniques

Over time, CPR techniques have evolved, and the practice of mouth-to-mouth has been largely replaced by hands-only CPR. This technique involves chest compressions only, without the mouth-to-mouth component, which reduces the risk of contamination and the psychological impact on the rescuer.

Current Recommendations

According to the latest guidelines from organizations such as the American Heart Association, hands-only CPR is more effective and less likely to lead to complications like vomiting or other forms of contamination. The focus is now on ensuring that rescuers are trained in this technique and can provide high-quality chest compressions.

The Question of Survival

While the experiences I described above may have been distressing, they also highlight a critical question: do CPR techniques and their proper application truly increase a patient's chance of survival? Statistics show that the overall survival rate for patients who receive CPR in public places is around 10% to 15%, with only about one in ten people surviving to leave the hospital.

Factors Influencing Survival

Several factors can influence a patient's chance of survival, including the timing of CPR, the quality of the technique, and the presence of other health conditions. Even with proper CPR, many patients do not survive.

Conclusion: A Consideration of Risk and Reward

Every EMT or first responder faces the decision of whether to continue with a potentially contaminated technique or to adopt a safer method. The experience I described is a reminder of the risks involved in resuscitation and the importance of continually updating and improving CPR techniques.

The key takeaway is that while CPR is a vital lifesaving skill, its effectiveness is directly related to the method and the trained personnel performing it. Moving away from mouth-to-mouth resuscitation towards hands-only CPR is not just a matter of hygiene; it is a step towards enhancing the quality and safety of resuscitation efforts.

By investing in training and protocols that ensure the highest quality of care, we can improve the odds of survival for those in need of resuscitation. Let's continue to evaluate and refine our practices to save more lives.