Mouth-to-Mouth Rescue Breathing: Step-by-Step CPR Guide (2024 Guidelines)

For lay rescuers: Current AHA guidelines prioritize Hands-Only CPR (compressions only) for adult sudden cardiac arrest. Rescue breaths remain essential for: children/infants, drowning, drug overdose, asphyxial arrest, or if trained and willing.

Rescue Breathing Sequence (Integrated with Compressions)

1. Check Responsiveness: Tap shoulders, shout "Are you okay?" No response → shout for help, activate EMS (911), get AED.
2. Open Airway: Head-tilt/chin-lift (trauma: jaw thrust). Look/listen/feel for breathing ≤10 sec.
3. If Not Breathing / Only Gasping:
   • Pinch nose sealed.
   • Seal mouth over victim's mouth (adult/child) or mouth+nose (infant).
   • Give 2 breaths (1 sec each), watching for chest rise.
   • If no rise: reposition head, re-attempt. If still no rise → proceed to compressions (assume obstruction).
4. Begin Cycles: 30 compressions : 2 breaths (adult/child/infant single rescuer).
   • Compressions: center of chest, 2–2.4" depth (5–6 cm), 100–120/min, full recoil.
   • Minimize interruptions <10 sec.
5. Continue Until: AED arrives/analyzes, EMS takes over, victim moves/breathes, or rescuer exhausted.

Critical Modifications

• Two Rescuers: 15:2 ratio (child/infant); switch compressors q2min.
• Advanced Airway (ETT/Supraglottic): Continuous compressions + 1 breath q6 sec (10/min) – no pause.
• Opioid Overdose: Rescue breathing + naloxone priority; compressions if no pulse.

Training Imperative

Take an AHA/Red Cross Heartsaver or BLS course. Skills decay rapidly; manikin practice builds muscle memory. Doing something is better than nothing—push hard, push fast.