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- Step 2: Open the airway
- Step 3: Give rescue breaths
- Frequency of breaths
- Calling triple zero (000)
- What to expect during your call to triple zero (000) – ambulance
- When is CPR needed?
- DRSABCD (or ‘doctors ABCD’)
- Steps before giving CPR to babies and young children
- How to give CPR to babies 0-12 months
- Mouth-to-mouth on babies (0-12 months)
- How to give CPR to young children 1-5 years
- Mouth-to-mouth on children (1-5 years)
- How to give CPR to adults and older children
- Popular tunes can help keep the rhythm of compressions
- Mouth-to-mouth on adults and older children
- Can it be dangerous doing chest compressions?
- Automated external defibrillators (AED)
- Where to get help
Rescue breathing is a type of first aid that’s given to people who have stopped breathing. During rescue breathing, you blow air into a person’s mouth to supply them with vital oxygen.
Rescue breathing can be done alone or as a part of cardiopulmonary resuscitation (CPR). The technique used can vary based on whether it’s being performed on an adult or a child.
In this article, we’ll discuss the rescue breathing technique in more detail, when it’s needed, and how it differs from CPR.
Oxygen is essential for life. When you breathe, oxygen enters your bloodstream through tiny air sacs in your lungs called alveoli. Once in your bloodstream, oxygen can travel to every part of your body.
Rescue breathing is a first aid technique that’s done when someone has stopped breathing (also known as respiratory arrest). Rescue breathing is also referred to as mouth-to-mouth resuscitation.
Situations that may cause breathing to stop can include the following:
When you perform rescue breathing, you gently blow air into a person’s mouth. This helps supply them with vital oxygen until medical help arrives.
Rescue breaths can be given alone or as a part of CPR. Because of this, you may be wondering how the two are different.
Rescue breaths can be given alone when a person has a pulse but isn’t breathing. CPR is done when a person’s heartbeat and breathing have stopped. CPR involves cycles of chest compressions and rescue breathing.
It’s not uncommon for cardiac arrest (stopping of the heartbeat) to happen shortly after respiratory arrest. Because of this, you may find that giving CPR is more common in an emergency situation as opposed to giving rescue breaths alone.
There are some instances where rescue breathing isn’t recommended. This is most applicable when rescue breathing is given as a part of CPR.
The American Heart Association (AHA) updated their CPR guidelines in 2010. In these new guidelines, the AHA recommends:
- People without CPR training give hands-only CPR. This is CPR that uses only chest compressions without rescue breaths. In this situation, you’d give quick, uninterrupted chest compressions until help arrives.
- Chest compressions come before rescue breathing. You may have heard of the ABCs of first aid, which stands for airway, breathing, and compressions. This acronym has now been updated to CAB (compressions, airway, breathing), with chest compressions ahead of breathing.
These changes came about because the process of opening the airway and effectively giving rescue breaths can take up vital time. Under the new guidelines, promptly starting chest compressions can help pump still-oxygenated blood to the body’s tissues.
Research supports these changes. For example, a 2017 review found that, when CPR is given by a bystander, just giving chest compressions increased survival compared to CPR that involved both chest compressions and rescue breathing.
If you encounter someone who is unresponsive and isn’t breathing, call 911. If you’re in a group, ask another person to call while you proceed to the next step.
Important notes: In a situation where someone has a pulse but isn’t breathing, it’s important to be aware of the following:
- Someone who isn’t breathing or isn’t breathing well may make occasional gasping sounds. This isn’t the same thing as normal breathing.
- Respiratory arrest can sometimes happen before cardiac arrest. If at any point you notice that the person’s pulse has stopped, begin CPR immediately.
Step 2: Open the airway
To effectively give rescue breaths, it’s essential that the person’s airway is open and clear. To open a person’s airway, do the following:
- Place your hand on their forehead.
- Gently tilt their head back.
- Use the fingers of your other hand to carefully lift their chin upward.
Step 3: Give rescue breaths
Now that the airway is open, you can proceed to give rescue breaths. To do this:
- Use the fingers of one hand to pinch the person’s nostrils shut. This helps to prevent air from escaping through their nose.
- Cover their mouth with yours, forming a seal so that air doesn’t escape.
- Give rescue breaths by gently breathing into their mouth. A rescue breath should last about 1 second. Aim to give a rescue breath every 5 to 6 seconds. This is about 10 to 12 breaths per minute.
- Check to see if the person’s chest rises as you give the first rescue breath. If it doesn’t, repeat step 2 (open the airway) before giving additional rescue breaths.
- Continue giving rescue breaths until emergency medical services (EMS) arrives or the person begins breathing normally on their own.
Important note: It’s also possible to give rescue breaths mouth-to-nose. This is an option when a person’s mouth is too injured to effectively give rescue breaths using a mouth-to-mouth technique.
The steps for rescue breathing on a child or infant are similar to those for adults. However, there are some important things to be aware of.
Technique
The technique used for rescue breaths can depend on the size of the child:
- Infants and small children. Form a seal around both the mouth and nose when giving rescue breaths. If it’s difficult to form a good seal this way, try a mouth-to-nose or mouth-to-mouth technique instead.
- Older children. Use the mouth-to-mouth technique.
Frequency of breaths
The number of breaths given per minute is slightly higher for children and infants than for adults.
Aim to give 12 to 20 rescue breaths per minute for a child or infant that isn’t breathing. This is about 1 rescue breath every 3 to 5 seconds.
If you’d like to be trained in CPR and rescue breathing, consider checking out classes offered by the American Red Cross or American Heart Association.
Local resources like schools and fire departments may have classes as well.
Rescue breathing is a type of first aid that’s used if someone has stopped breathing. During rescue breathing, you gently breathe into a person’s mouth every few seconds. This helps provide them with oxygen until help arrives. Rescue breathing isn’t the same as CPR.
CPR is done when a person isn’t breathing and doesn’t have a pulse. It involves cycles of chest compressions and rescue breathing. However, it’s recommended that individuals that aren’t trained in CPR only give chest compressions, without rescue breathing, if someone doesn’t have a heartbeat.
Call triple zero (000) for an ambulance in an emergency to get medical assistance. Common emergency situations for adults and children include:
Calling triple zero (000)
Some people hesitate in calling triple zero because they don’t believe their situation qualifies as an emergency. If in doubt, call 000 – the operator will direct you to the help you need.
Emergency phone operators are trained to help you and can provide advice about what you need to do while you're waiting for emergency services to arrive.
What to expect during your call to triple zero (000) – ambulance
When you call triple zero (000), you will be asked which service you require. Tell the operator you need an ambulance. You will then be transferred to an ambulance operator and asked for the following information:
- The location you need the ambulance to respond to. If the address if known, provide this to the operator.
- If the address is not known, be sure to tell the operator any additional information that may assist. This may include street or road names, parks, emergency marker details , or any other landmarks nearby.
- Details of the situation and what has happened.
- How many people require medical assistance.
- The injured person’s age and sex.
- Whether the person is conscious or breathing.
The operator will organise assistance for you while you continue talking on the phone, even though you may not hear them do this.
Answer any of the operator’s questions as this can help the paramedics prepare their response before the ambulance reaches you.
The operator may give you first aid instructions over the phone. If you can, put your phone on loudspeaker.
Do not hang up until the phone operator tells you to.
When is CPR needed?
CPR is most successful when administered as soon as possible. CPR is required when a person is:
- unconscious
- not breathing normally
- not breathing.
A person in cardiac arrest may grunt, snort or take gasping breaths – this is not normal breathing. They still need CPR – don’t wait until they stop breathing.
Although CPR steps are the same for adults and older children, the technique for babies and young children (0-5 years) is slightly different.
DRSABCD (or ‘doctors ABCD’)
The steps involved in CPR are known as DRSABCD:
D – DangerR – ResponseS – Send for helpA – AirwayB – BreathingC – CPR
D – Defibrillator
You may like to call it ‘doctors ABCD’ (DRS ABCD) so you can remember each step.
Steps before giving CPR to babies and young children
- D= Danger – look for the source of any danger and make sure you and your child are safe.
- R= Response – check for a response from your child as if you are trying to wake them up. For instance, speak loudly, gently squeeze them or tickle their feet.
- S = Send for help if your child is not responding. Call 000 and ask for an ambulance. Don’t leave your child unattended.
The emergency services operator will guide you through CPR until the ambulance arrives.
How to give CPR to babies 0-12 months
This video is available in a version aimed at Aboriginal communities , and also in the following languages:
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
To perform CPR on infants (0-12 months):
- A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth).
- Make sure your baby is in a neutral position (such as on their back) with their head and neck in line. Do not tilt their head back or lift their chin.
- B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position).
- If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR.
- C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
- Lie your baby on their back.
- Place 2 fingers on the lower half of your baby’s breastbone (in the middle of their chest).
- Press down with your fingers (or palm for babies over 6 months) to about a third of the depth of their chest, then release to the rest position.
- This counts as one compression.
Note: You may need to use the palm of your hand instead of your fingers depending on the size of your baby.
Mouth-to-mouth on babies (0-12 months)
- Make sure your baby is resting in the neutral position and that their head and neck is not tilted.
- Gently lift their chin – be careful not to rest your hands on their throat as this could restrict air getting into their lungs.
- Take a small breath and cover your baby’s nose and mouth Blow gently for about one second watching for the chest to rise.
- After each breath watch for your baby’s chest to fall. Place your ear and face close to your baby’s ear and nose to see if air is being expelled.
- If your baby’s chest is not rising, gently check again for any blockages and remove them.
- Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
- Your baby recovers (they start to move, breathe normally, cough or cry). Then put them in the recovery position (onto their side).
- The ambulance arrives and the paramedics take over.
Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your baby’s life.
How to give CPR to young children 1-5 years
This video is also available in the following languages:
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
To perform CPR on children (1-5 years):
- A=Airways – check your baby’s airways (nose, mouth and throat) are clear. Remove any blockage (such as vomit, blood, food or loose teeth).
- Make sure your child is in a neutral position (such as on their back). Gently tilt their head back and lift their chin.
- B=Breathing – is your child breathing normally? If so, gently roll them onto their side (known as the recovery position).
- If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to perform CPR.
- C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
- Lie your child on their back. Kneel beside them.
- Place the heel of one hand on the lower half of your child’s breastbone (in the middle of their chest).
- Position yourself above your child’s chest.
- Keep your arm straight and press down on their chest to a third in depth, then release the pressure.
This counts as one compression.
Mouth-to-mouth on children (1-5 years)
- Open your child’s airway by gently placing one hand on their forehead and the other hand on their chin to tilt their head back.
- Pinch the soft part of their nose closed with your index finger and thumb.
- With your other hand, open their mouth with your thumbs and fingers.
- Take a breath and place your lips over your child’s mouth. Ensure you have a good seal so no air can escape.
- Blow steadily for about one second, watching for the chest to rise.
- After each breath watch for their chest to fall. Listen and feel for signs that air is being expelled.
- Maintain the chin lift and tilt position – take another breath and repeat.
- If your child’s chest is not rising, check again for any blockages and remove them. Then keep going with mouth-to mouth, making sure their head is lifted, chin tilted. Ensure that no air is escaping.
- Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
- Your child recovers (they start to move, breathe normally, cough or talk). Then put them in the recovery position (onto their side).
- The ambulance arrives and the paramedics take over.
D= Defibrillator – CPR must be continued until an automated external defibrillator (AED) becomes available, the pads are attached and the machine is turned on.
Remember, if you are finding it difficult to keep up mouth-to-mouth breathing, keep going with compressions – they can still save your child’s life.
How to give CPR to adults and older children
Aim for 5 sets of 30 chest compressions to 2 breaths in about 2 minutes.
If you can’t do mouth-to-mouth, stick with continuous compressions at a rate of approximately 100 per minute.
To perform CPR on adults and older children:
- A=Airways – open the person’s airways (nose, mouth and throat) and check they are clear. Remove any blockage (such as vomit, blood, food or loose teeth). Don’t spend too much time doing this – CPR is your main priority.
- Make sure the person is in a neutral position (such as on their back). Gently tilt their head back and lift their chin.
- B=Breathing – are they breathing normally? If so, gently roll them onto their side (known as the recovery position).
- If they are not breathing or breathing abnormally (such as grunting or gasping for air) you will need to give them CPR.
- C=CPR consists of 2 techniques – 30 chest compressions and 2 breaths of mouth-to-mouth.
Chest compression steps
Place the heel of one hand on the lower half of the person’s breastbone (in the middle of their chest).
- Place your other hand on top of your bottom hand and grasp your wrist. Or you may like to interlock your fingers – depending on what feels comfortable.
- Keep your arms straight and press down on their chest by one third of their chest depth.
- Release the pressure – this counts as one compression.
Popular tunes can help keep the rhythm of compressions
To keep the correct rhythm of compressions, you may like to use these popular songs:
- ‘Staying alive’ by the Bee Gees
- ‘Row, row, row, your boat’
- ‘Baby shark’.
Mouth-to-mouth on adults and older children
- If the person is not breathing normally, make sure they are lying on their back on a firm surface.
- Open the airway by tilting the head back and lifting their chin.
- Close their nostrils with your finger and thumb.
- Put your mouth over the person’s mouth and blow into their mouth. Make sure no air is leaking.
- Give 2 full breaths to the person (this is called ‘rescue breathing’).
- Check their chest is rising and falling. If this is not happening, tilt their head back, pinch their nostrils tightly and seal your mouth to theirs.
- If still no luck, check their airway for any obstruction.
- If you cannot get air into their lungs, go back to chest compressions – this may help shift an obstruction.
- Continue to give 30 chest compressions, followed by 2 breaths (30:2). Aim for 5 sets of 30:2 in about 2 minutes.
Keep going until:
- The person becomes responsive. They may begin to move, breathe normally, cough or talk. Then put them in the recovery position (onto their side).
- The ambulance arrives and the paramedics take over.
CPR can be tiring. If you need a break, ask someone else to assist with minimal disruption. Rotate the person performing compressions every 2 minutes.
If you find mouth-to-mouth difficult, continue with chest compressions until medical help arrives. They can still save someone’s life.
Can it be dangerous doing chest compressions?
Sometimes, people will have their ribs broken by chest compressions. This is still better than the alternative of not receiving CPR.
If this occurs, pause and reposition your hands before continuing or get someone else to take over.
Automated external defibrillators (AED)
D= Defibrillator – A defibrillator is a life-saving device that treats someone who is having a cardiac arrest. It can analyse abnormal heart rhythms and send an electric shock or pulse to get the heart to return to its normal pumping rhythm.
CPR must be continued until an automated external defibrillator (AED) becomes available. The pads must be attached to the skin and the machine turned on.
AEDs are easy to use – voice prompts tell you what to do.
There are different types of AEDs and some are available in public places (such as shopping centres and schools).
It is important to follow the prompts on the AED. Do not touch the person during analysis or shock delivery.
If there is an emergency, knowing simple first aid can mean the difference between life and death. Consider taking a first aid course. CPR can be life-saving first aid – it increases someone’s chances of survival until an ambulance arrives.
First aid training courses are available across Australia. A course typically takes a couple of hours and can be taken online or in person. Times are also flexible.
Participants learn basic first aid skills (including CPR) and usually receive a certificate. Follow up refresher courses are recommended every 3 years.
Many organisations hold regular courses, ask your doctor or maternal and child health nurse for more information.
Where to get help
- Australian Resuscitation Council (ARC) Guidelines , Australian Resuscitation Council
- Guideline 8, Cardiopulmonary Resuscitation , 2021, Australian Resuscitation Council and New Zealand Resuscitation Council
- DRSABCD Action Plan: First Aid Fact Sheet(PDF) ,St John Ambulance Australia
- Sayre MR, Berg RA, Cave DM, et al. 2008, ‘Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest’ , Circulation, vol. 117, pp. 2162-2167
- White L, Rogers J, Bloomingdale M, et al. 2010, ‘Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest’ , Circulation, vol. 121, pp. 91-97
- Matlock D, Hafner JW, Jr, Bockewitz EG, et al. 2008, 83: "Stayin’ Alive”: a pilot study to test the effectiveness of a novel mental metronome in maintaining appropriate compression rates in simulated cardiac arrest scenarios , Annals of Emergency Medicine, vol. 52, no. 4, pp. S67-68
- Victorian Ambulance Cardiac Arrest Registry (VACAR) Annual Report , Ambulance Victoria
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This page has been produced in consultation with and approved by:
This page has been produced in consultation with and approved by:
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