Table of Contents
- What Is Rescue Breathing?
- Ventilation Versus Oxygenation
- Bag Valve Masks Versus Rescue Breathing
- Rescue Breathing & Ventilation Rates
- Rescue Breathing FAQs
A child is pulled from a swimming pool, unresponsive. A teenager collapses during a basketball game, not breathing. A baby suddenly stops moving in their crib. In moments like these, panic can easily take over. However, for someone trained in CPR, instinct kicks in instead.
They spring into action, starting with chest compressions to keep blood flowing throughout the body. Once circulation is underway, they move to rescue breathing. While chest compressions keep blood circulating, rescue breathing restores the oxygen the body desperately needs. Without it, the brain and heart can begin to fail within minutes.
Knowing the seven easy steps for CPR, including how to deliver rescue breaths at the correct rate, gives you the best chance of saving a life. The right training will empower you to act fast, which is vital—because emergencies don’t wait for help to arrive.
Read on to learn more about rescue breathing and ventilation rates for adults, children, and infants.
What Is Rescue Breathing?
Rescue breathing is a simple technique that involves giving breaths to a person who has a pulse to keep essential oxygen flowing throughout their body until professional help arrives.
Without this temporary replacement for natural breathing, the body quickly begins to shut down.
This technique is often used alongside other emergency interventions like chest compressions during CPR, though it can also be performed on its own. It’s a skill that anyone can learn and apply in a range of respiratory arrest emergencies, such as certain overdoses, severe allergic reactions, near-drownings, severe asthma attacks, and shock, among others.
The simplicity of rescue breathing makes it accessible to both trained professionals and bystanders so help can be provided quickly.
The Purpose of Rescue Breathing
Rescue breathing is all about giving someone a fighting chance when they need it most. The body relies on a steady supply of oxygen to function, and without it, essential systems stop working. The brain starts taking on damage, and the heart may stop pumping effectively soon after.
Rescue breathing:
- Keeps vital organs alive. Oxygen is used to fuel the brain, heart, and other organs in the body. Rescue breathing keeps them active until natural breathing can resume.
- Prevents irreversible damage. Lack of oxygen can cause permanent brain damage within 4-6 minutes. Rescue breathing buys precious time to avoid long-term effects.
- Supports recovery. Stabilizing the person with rescue breathing creates a foundation for professional medical interventions to be more effective, giving them the best possible chance to regain normal function after the emergency.
The purpose is simple but profound — rescue breathing helps sustain life and prevent harm during those moments when every second matters.
When to Use Rescue Breathing
Rescue breathing can be used as part of CPR or on its own without the use of chest compressions.
Rescue Breathing Without CPR
There are many cases when rescue breathing should be used on its own, particularly when a person has a pulse but isn’t breathing. The priority in these cases is delivering oxygen to the person’s body as quickly as possible. Here are several situations in which you may use rescue breathing without chest compressions:
- Near Drowning: If a near-drowning victim has a pulse but isn’t breathing, prioritize mouth-to-mouth rescue breaths to provide the best chance of a positive outcome.
- Drug Overdose: If an overdose victim has a pulse but isn’t breathing, perform rescue breaths. Drugs — particularly opiates — can lead to respiratory depression or decrease the functioning of the respiratory system.
- Asthma Attack & COPD: In the case of severe asthma attacks or COPD, because the obstruction in the respiratory system has caused an oxygen shortage, rescue breaths are essential if the victim has a pulse but becomes unresponsive and stops breathing.
- Trauma: If a victim has suffered physical trauma and has a pulse but isn’t breathing, rescuers should start performing rescue breaths right away.
- Poisoning: If you suspect someone has ingested something poisonous and has a pulse but is no longer breathing, perform rescue breaths.
- Diabetic Emergencies: If you suspect someone is having an emergency caused by diabetes and he or she has a pulse but isn’t breathing, perform rescue breaths.
- Stroke: In some stroke cases, the person may have a pulse but stop breathing. If you suspect a stroke, perform rescue breaths to ensure oxygen is getting to the lungs.
- Post-Cardiac Arrest: If a person has suffered a cardiac arrest and their pulse has been restored with CPR, continue performing rescue breaths until professional helps arrives.
To learn more, view our complete guide to mouth-to-mouth rescue breaths here.
Rescue Breathing During CPR
During CPR, provide 30 chest compressions, followed by 2 rescue breaths, regardless of the person’s age. However, you should adjust your rescue breathing technique based on the victim’s age to account for differences in size and lung capacity:
- For adults: Provide 30 chest compressions, then give 2 rescue breaths lasting about one second each. Be sure the chest visibly rises with each breath, indicating effective airflow.
- For children: Provide 30 chest compressions, then give 2 rescue breaths lasting about one second each. Watch for visible chest rise without overinflating. Use smaller, gentler breaths to accommodate their smaller lung capacity.
- For infants: Provide 30 chest compressions, then give 2 soft rescue breaths lasting about 1 second each, just enough to see the chest rise without risking overinflation. Be sure to cover both the infant’s nose and mouth with your mouth when providing rescue breaths.
Tailoring rescue breaths to the person’s age and size makes the technique both safe and effective.
Ventilation Versus Oxygenation
Breathing is often oversimplified as the simple act of air moving in and out of the body, but it’s actually a complex process involving multiple systems working together to sustain life. When a person breathes in, oxygen-rich air enters the lungs and the chest expands through the coordinated effort of the diaphragm and intercostal muscles, creating negative pressure.
This oxygen is then absorbed into the bloodstream through tiny air sacs in the lungs called alveoli. At the same time, carbon dioxide, a waste product of cellular metabolism, moves from the bloodstream into the lungs to be exhaled.
This exchange of gases is known as ventilation, or external respiration, and it’s crucial for maintaining the balance of oxygen and carbon dioxide in the body.
However, ventilation is only one part of the process. The alveoli also facilitate oxygenation, where oxygen moves from the lungs into the circulatory system. Hemoglobin in red blood cells binds to the oxygen and carries it through the bloodstream to tissues and organs that receive the energy they need to function.
Simultaneously, carbon dioxide is transported back to the lungs for exhalation. The circulatory system plays a key role in this process, ensuring oxygen-rich blood reaches every part of the body while removing waste gases efficiently.
These processes are interconnected and essential for survival, highlighting the complexity of what seems like a simple action. Without proper ventilation, the body can’t exchange gases effectively, leading to oxygen deprivation, carbon dioxide buildup, and a lack of energy for the body’s functioning.
Without oxygenation, tissues and organs can’t receive the oxygen they need, which can lead to rapid organ failure. Understanding these intricacies reinforces the importance of immediate interventions like rescue breathing and CPR in emergencies, where even a brief disruption in this delicate system can have life-threatening consequences.
Bag Valve Masks Versus Rescue Breathing
Bag valve masks and traditional rescue breathing methods both aim to deliver oxygen to a victim in need, but they differ in their application, accessibility, and effectiveness.
A bag valve mask is a device used to provide airflow into a victim’s lungs without requiring direct mouth-to-mouth contact. Commonly used by healthcare professionals, these devices require additional training to use effectively and are often combined with advanced airway management techniques.
One of the key challenges of using a bag valve mask is maintaining a proper seal on the victim’s face, which is essential for effective oxygen delivery. However, the benefits of these devices are significant. The self-inflating bag reduces the physical strain on the person providing care, allowing them to continue administering aid longer.
Additionally, bag valve masks can deliver a higher concentration of oxygen compared to traditional rescue breathing methods, making them particularly useful in emergencies.
While the risk of disease transmission from mouth-to-mouth rescue breathing is extremely low when performed correctly, many rescuers may feel more comfortable using a barrier device like a face shield or pocket mask. All methods require physical effort and can quickly exhaust the person providing care, particularly during prolonged CPR.
Rescue breathing can be performed using a bag valve mask, a face shield, a pocket mask, or direct mouth-to-mouth contact.
Both bag valve masks and traditional rescue breathing methods play key roles in emergency care, with each having its own strengths and limitations. Understanding these tools and how to use them effectively can make a significant difference in providing lifesaving aid.
Rescue Breathing & Ventilation Rates
As the oxygenation process is underway, it’s important that suitable levels of oxygen remain in the blood so body tissues have the needed oxygen for cellular respiration. This is where the proper rescue breathing rate becomes critical.
Following the correct rescue breathing rate improves oxygen delivery by mimicking natural breathing patterns giving the body the oxygen it needs without overwhelming the lungs or circulatory system.
The American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) meet every five years to update all CPR guidelines, including recommendations on rescue breathing and ventilation rates. These guidelines emphasize the importance of maintaining the correct rescue breathing rate to avoid complications.
Delivering breaths too quickly or forcefully can reduce the effectiveness of oxygen exchange and lead to dangerous increases in intrathoracic pressure, potentially affecting blood flow to the heart. It can also cause barotrauma, pulmonary contusions (bruises on the lungs), or gastric inflation.
Gastric inflation, where air enters the stomach instead of the lungs, can result in vomiting or aspiration, further complicating the situation. Adhering to the proper breathing rates minimizes these risks and maximizes the benefits of rescue breathing.
For rescue breathing to be effective, rescuers should also keep the following in mind:
- Check for an adequate pulse. Adults’ pulses can be felt on the neck or wrist, and usually a pulse between 60 and 100 beats per minute is normal. For infants and younger children, an adequate pulse is usually above 100 beats per minute.
- Initiate CPR if necessary. If the pulse is inadequate or absent, perform 30 compressions for every 2 breaths.
- Focus on visible chest rise. Each breath should be delivered steadily enough to cause a visible chest rise, a key sign of effective oxygen delivery.
- Avoid overventilating. Deliver breaths slowly and steadily to prevent complications like gastric inflation or excessive pressure in the chest.
When rescuers follow proper rescue breathing rates and techniques, they can improve oxygen delivery, reduce the risks of complications, and provide the best possible care in an emergency.
Here are the most recent 2020 guidelines for rescue breathing and ventilation rates.
Rescue Breathing for Adults
When providing rescue breaths to an adult, maintaining proper technique and rhythm is essential for effective oxygen delivery and avoiding potential complications. Adults require approximately 10 breaths per minute, which translates to one breath every 6 seconds.
This slower rate accommodates their larger lung capacity and the efficiency of fully developed alveoli in facilitating gas exchange.
Here are safety tips for administering rescue breaths to adults:
- Use the head tilt–chin lift maneuver. Open the airway by tilting the head back and lifting the chin. This prevents the tongue from obstructing the airway and allows air to flow freely into the lungs.
- Maintain a consistent rhythm. Deliver one breath every 6 seconds, keeping each breath steady and controlled. Counting in your head can help you stay on track with the timing.
- Avoid excessive ventilation. Deliver only enough air to make the chest visibly rise. Overinflating the lungs can increase intrathoracic pressure, reduce blood flow to the heart, and lead to complications like gastric inflation.
- Monitor the chest rise. Watch the chest to ensure it rises with each breath, indicating effective oxygen delivery. If the chest doesn’t rise, recheck the airway for obstructions or improper positioning.
- Seal properly. Create a tight seal over the person’s mouth using your own mouth or a barrier device, like a pocket mask or face shield, to deliver the air directly into their lungs.
- Adjust for physical challenges. If the person has facial injuries or a difficult airway, consider alternative techniques or repositioning the head and neck to improve airflow.
Following these guidelines makes the breaths provided effective while reducing the risk of complications.
Rescue Breathing for Children
Administering rescue breaths to children requires careful consideration of their smaller lung capacity and unique physiology. Delivering breaths too forcefully or quickly can cause complications like gastric inflation, where air enters the stomach instead of the lungs, potentially leading to vomiting or aspiration.
Gentle breaths that cause the chest to visibly rise are essential for safe and effective oxygen delivery. Children older than one year should receive a breath every two or three seconds to maintain a rate of 20 to 30 breaths per minute.
This high rate of rescue breaths is needed due to a child’s smaller lungs and higher metabolism rates.
Rescue Breathing for Infants
Rescue breaths for infants require special care due to their delicate physiology. Their smaller lung capacity and underdeveloped structures make them more susceptible to injury from excessive force during ventilation.
For safety and effectiveness:
- Use minimal force. Deliver gentle puffs of air, just enough to see the chest rise. This approach helps prevent lung damage and reduces the risk of air entering the stomach, which can lead to complications like vomiting or aspiration.
- Create a proper seal. Make sure to fully cover both the infant’s mouth and nose with your own mouth when providing rescue breaths.
Recent guidelines recommend providing rescue breaths at a rate of 20-30 breaths per minute for infants under one year old, equating to one breath every two to three seconds.
This rate accommodates their higher metabolic demands and smaller lung volumes, confirming effective oxygenation without overinflation.
When it comes to CPR and rescue breathing, knowing the correct techniques and rates for adults, children, and infants can make all the difference in an emergency.
These skills are more than following guidelines; they’re about providing the right support needed to save a life — either through recognizing respiratory distress, understanding the tools like bag valve masks, or delivering effective rescue breaths.
CPR and rescue breathing are essential skills that everyone should know, but they require practice and confidence to perform effectively. Formal training makes you ready to act when every second counts and gives you the knowledge and skills to respond to emergencies with clarity and purpose.
Take the first step in being prepared today. Contact ProTrainings to learn how we can help you and your team become CPR-certified.
Rescue Breathing FAQs
Rescue breathing is a critical component of first aid, and while the concept may seem straightforward, many people have questions about the specifics, such as proper techniques, timing, and safety considerations. Below, we answer some of the most common questions about rescue breathing so you can act confidently in emergencies.
- Why are the rescue breathing rates different for adults, children, and infants?
The rates vary because of differences in lung size and oxygen needs. Adults require slower, deeper breaths due to their larger lungs, while children and infants need gentler, faster breaths to match their smaller lungs and higher metabolic rates. - How can I know if I am giving breaths too fast or too slow?
Watch for chest rise. Each breath should last about one second, causing the chest to rise visibly but not excessively. Timing your breaths (e.g., one every 6 seconds for adults) can also help maintain the correct pace. - What should I do if I don’t see the chest rising?
Recheck the airway using the head tilt–chin lift maneuver and secure the seal over the mouth (and nose for infants). If the chest still doesn’t rise, there may be an obstruction, requiring full CPR and checking the airway for the obstruction.
- Can I practice rescue breathing without certification?
Yes, but formal training is highly recommended. Certification programs provide hands-on practice and expert guidance to confirm you’re performing the technique effectively and safely. - How do I know if I’m giving rescue breaths at the right rate?
Count the seconds between breaths and monitor for chest rise. Practicing during CPR training can help you develop a natural rhythm and ensure your breaths are effective. A metronome app on your phone can help you keep time. Another option is to call 911 and have the operator count for you while you wait for help to arrive.
- Is rescue breathing always performed with mouth-to-mouth?
No, it can also be done with tools like pocket masks or bag valve masks, which are often preferred for safety and efficiency. These devices deliver oxygen while minimizing direct contact.
Understanding the nuances of rescue breathing is the foundation of providing the proper care in emergencies.