CPR and Infection Risk: Universal Precautions and Barrier Devices

CPR carries very low but non-zero infection risk. Pathogens potentially transmitted via saliva, blood, vomitus: HBV, HCV, HIV, TB, respiratory viruses (influenza, COVID-19).

Universal Precautions for Lay Rescuers

• Hands-only CPR (chest compressions only) for adults — eliminates mouth-to-mouth exposure. Recommended for untrained bystanders.
• Barrier devices: Pocket mask with one-way valve, face shield with filter — for rescue breaths if trained/willing.
• Gloves: If available, wear for contact with blood/body fluids.
• Hand hygiene: Wash thoroughly before/after; alcohol-based sanitizer if soap unavailable.

Healthcare Providers

• Standard PPE: gloves, gown, eye protection, N95/equivalent for aerosol-generating procedures (bag-mask ventilation, intubation).
• Use bag-valve-mask with HEPA filter; avoid direct mouth-to-mouth.
• Post-exposure protocol: report needlestick/mucosal exposure; baseline + follow-up testing per protocol.

Risk Perspective

No documented HIV transmission from CPR. HBV transmission documented but rare (pre-vaccine era). Benefit of bystander CPR (2–3x survival) vastly outweighs theoretical infection risk.

Do not hesitate to start CPR. Use hands-only if no barrier; use barrier if available and trained.