Hands-Only CPR: No More Mouth-to-Mouth?

What Is Hands-Only Cardio-pulmonary Resuscitation (CPR)?

In April, 2008, the American Heart Association (AHA) took steps to simplify the process of helping victims of cardiac arrest by introducing "hands-only" CPR. Since only about 1/3 of people who suffer a cardiac arrest at home or at a public place actually receive help, bystanders could be afraid to initiate CPR for fear that they'll do something wrong or won't know what to do. Others may be reluctant to perform mouth-to-mouth breathing for fear of contracting an infection.

It is estimated that each year, around 310,000 Americans die of cardiac arrest that occurs at home or in a public place. The AHA proposed the new guidelines in order to allow bystanders who have not been trained in conventional CPR or who may fear making a mistake a way to offer help.

What Are the Steps in Hands-Only CPR?

In short, the procedure for "hands-only" CPR is simple. An untrained bystander who sees an adult suddenly collapse (after verifying that the person is unresponsive and is not breathing) should do just two things:

  1. Call 911 (or send someone else to do this if you are not alone), and if others are present, send someone to find an AED (automated external defibrillator).
  2. Push hard and fast in the center of the chest. The rate should be fast, about 100 presses per minute, but it's not necessary to count. Just initiate deep, rapid, continuous presses on the center of the chest and continue until the victim awakens, an AED is found, or emergency personnel arrive.

Hands-only CPR eliminates the mouth-to-mouth breathing of conventional CPR (alternating 30 chest presses and two quick breaths).

When Should I Use Mouth-to-Mouth?

Although hands-only CPR is very effective, it is not as beneficial as conventional CPR in a patient who is not breathing.

In all children, and in adults who collapse after a near-drowning, drug overdose, or carbon monoxide poisoning, mouth-to-mouth breathing should still be included to get air into the lungs.

Studies have shown that hands-only CPR can be as effective as conventional CPR and may save lives. Those who have been trained in conventional CPR may still opt to use conventional CPR instead of the hands-only technique.


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Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care


"Basic life support (BLS) in adults"