Lowering the risk of infection when giving breaths during CPR involves using barriers, proper hygiene, and protective gear, along with good technique and training. Here are practical, evidence-aligned steps you can follow: What to use (barriers and PPE)
- Barrier devices: Use a face shield or a pocket mask with a one-way valve whenever possible. These barriers reduce direct exposure to respiratory droplets during rescue breaths. If a full barrier isn’t available, any improvised barrier that covers the mouth and nose is better than nothing. Ensure the device is compatible with one-way flow to protect the rescuer.
- Gloves: Wear disposable gloves to add a layer between hands and the patient’s fluids. Replace gloves if they become compromised, and avoid touching your face until gloves are removed and hands are washed.
- Eye protection and gown: When available, use eye protection (goggles or face shield) and a gown to guard against potential splashes in high-risk environments.
- Hand hygiene: Perform hand hygiene before and after providing breaths, using soap and water for at least 20 seconds or an alcohol-based hand sanitizer if soap isn’t available. This reduces the chance of transferring pathogens.
Technique and workflow
- Ensure a proper seal: When delivering breaths through a barrier, ensure a good seal around the barrier device with the patient’s mouth and nose (or as directed by the device instructions). Poor seal can require more breaths and increase exposure risk due to repeated attempts.
- Minimize breaths: Use rescue breaths that befit the situation and training. In many lay-responder scenarios, delivering breaths in sets of one breath every 6 seconds (roughly 10 per minute) during pulseless electrical activity or as recommended by trained CPR guidelines helps balance oxygenation with exposure risk. Always follow current local guidelines and training.
- Protective positioning: Perform breaths with your head and torso positioned to maximize chest rise while keeping yourself protected, and avoid leaning repeatedly into the patient’s face.
- Endotracheal intubation timing: If trained and equipped, rapid airway management (e.g., endotracheal intubation) can reduce aerosol generation compared with prolonged mouth-to-mouth breaths, but this requires advanced training and equipment and should be performed by qualified personnel to minimize delays.
- Environmental controls: If possible, perform CPR in a well-ventilated area to reduce concentration of infectious particles. Minimize interruptions to chest compressions, as longer pauses can affect outcomes but should not compromise safety.
Hygiene and decontamination
- Don and doff decontamination: Follow proper procedures for removing and disposing of PPE to avoid self-contamination. Dispose of single-use items in appropriate clinical waste containers.
- Post-event decontamination: After the incident, wash hands thoroughly and clean any surfaces or equipment that may have come into contact with the patient’s fluids according to local infection-control guidelines.
Training and preparedness
- Get certified and practice with barrier devices: Regular CPR training that includes barrier devices, proper donning and doffing of PPE, and safe rescue-breath techniques improves both effectiveness and safety.
- Know what’s available: In many settings, portable barrier devices and basic PPE kits are standard for first responders and healthcare providers. Being familiar with what is on hand helps you act quickly and safely.
If you want, I can tailor these guidelines to a specific scenario (lay rescuer, healthcare professional, or a particular environment like a school or workplace) and align them with the latest local guidelines you follow.
