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DO WE STILL DO MOUTH OF MOUTH?
The mouth-to-mouth technique
During the First Aid PSC1 and SST training, the trainees are taught to perform insufflations using two techniques: mouth-to-mouth (adult) and mouth-to-nose (infant). During a cardiac arrest, the victim does not breathe, the artificial ventilation therefore aims to breathe oxygen into the victim.
As a reminder, each time we breathe, we inhale air composed of 80% Nitrogen and 20% oxygen. During expiration, the air is then composed of 80% nitrogen, i.e. as much on arrival as on departure because this gas is not used by the cells of the body, 15% oxygen therefore a little less than at the start since this time, the cells have consumed a small part of it, which in exchange produces 5% carbon dioxide.
Mouth to mouth and cardiac massage?
Recently, the American Heart Association (AHA) published a recommendation suggesting that witnesses of cardiac arrest should perform chest compressions without ventilations. So, is it still necessary to ventilate during a cardiac arrest?
According to the European Resuscitation Council (ERC), the various studies published since its last recommendations cannot prove the effectiveness of stopping the insufflations. It is therefore recalled that it is always recommended to perform Cardiopulmonary Resuscitation (CPR) by alternating 30 compressions at a rate of 100-120 (pressure of 5 to 6 cm) per minute, with two breaths using the mouth- by mouth. Important note, it is necessary to reduce as much as possible the delay between the massage and the mouth to mouth.
However, for people who don't feel able to do word-of-mouth. In this case, limiting yourself to compressions alone is preferable. As mentioned during the training, it is better to give a bad massage than nothing at all, but avoid making bad insufflations.
For example, the State of Arizona recommends that witnesses of cardiac arrest no longer give mouth-to-mouth resuscitation and to content themselves with the practice of cardiac massage to circulate the blood. Except in three special cases: drowning, electrocution or when it comes to a child.
American College of Cardiology study
In addition, according to the results of the study published in the journal of the American College of Cardiology, they confirm the advantages of the non-mouth-to-mouth method, advocated the previous year by Professor Gordon Ewy, cardiologist at the University of Arizona. Also called “cardio-cerebral resuscitation”, this practice, the sole purpose of which is to circulate the blood to the heart and the brain, is based on robust physiological foundations. Because, when the heart stops beating suddenly, the blood generally contains enough oxygen to still supply the organs for 10 to 15 minutes. Provided, however, to circulate the blood through cardiac massage.
Source: the figaro health of 10/12/2012
SOS Kanto Group study
Another study also shows that the practice of mouth to mouth "is not necessary". The SOS Kanto Group study bringing together eight university hospitals in Tokyo and those of Saitama and Chiba (Japan) was able to verify that out of 4 cardiac arrests observed by passers-by, 241 had not been the subject of any maneuver. first aid; 2 had been resuscitated, for 917 of them by a simple external cardiac massage. 1 others received first aid care combining cardiac massage with mouth-to-mouth ventilation maneuvers. 324% of patients who only had chest massage presented, thirty days after successful resuscitation, a favorable neurological score (either that they had fully recovered their higher functions, or that they only had a qualified disability of moderate). Conversely, only 434% of subjects who had massage and mouth-to-mouth at the same time achieved a comparable neurological score.
The only thing safe in the future. It is that there may chance that it conforms to our expectations ...