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No more 'mouth to mouth' for the masses.

The most important rule in first aid, above all else, is to ensure your own safety and is why it takes pride of place at the top of the 'Primary Survey'.

As both a paramedic and first aid trainer, I only want positive outcomes from treatment given by first aiders, trained or untrained... and that starts with keeping yourself as safe as possible.

But as a Dad who encourages my and other's kids to help people when they may need first aid, especially cardiopulmonary resuscitation (CPR) if required, I hold a much closer, more emotionally attached role toward this little group of responders. Not ideal to have kids trying to save another's life, I know, but better than nothing at all and you never when it could be you or yours needing it.

Studies based on compressions-only or 'Just Hands' CPR have been carried out for over two decades to find the pros and cons of each.

Why is 'Just Hands' CPR preferred for the unprofessional responder?:

1. Easier to learn and recall

2. A greater willingness for bystanders to start CPR

3. Better chance of hearing instructions/advice via phone

4. Focus moved to quality compressions instead of the lesser priority of airway management

5. Reduced risk of body fluid contact, which is a major factor in bystanders withholding CPR

6. Reduced risk of assault by decreasing proximity to casualty and opening vision of scene

7. Reducing delays by removing the need to a) effect correct positioning of the head, neck, jaw, b) achieve an airway seal, and c) deal with problem airways in cases of incorrect technique or trauma

8. Improved out-of-hospital survival rates to Sudden Cardiac Arrest (SCA).

It was also found that compressions-only CPR is superior to standard CPR when carried out by untrained bystanders (the majority of first aiders fall into this group due to lack of practice and assessment); it significantly improved the chance of survival in dispatcher-assisted compressions-only CPR compared with conventional out-of-hospital CPR (Expired Air Resuscitation (EAR) + External Cardiac Compressions (ECC)); BUT, that 'Just Hands' CPR at a rate of 100-120/min is more tiring than the standard 30:2 method, therefore it is important to rotate those doing compressions around every two-four minutes to avoid poor technique (depth and rate) caused from fatigue.

The studies have conflicting findings on several areas such as the length of casualty down-time compared to eventual outcomes following 'Just Hands' CPR, but these matter little in the bystander CPR setting with all authors in agreement that having a go at CPR is far more important than bystanders withholding CPR because they are unwilling to provide rescue breaths which could potentially contact body fluids (even thought rates of cross-contamination in cardiac arrest are very low but a risk all the same) or mistake of techniques that are difficult to remember and carry out.

Be safe and remember that lessons in life-saving techniques can not only help save a life tomorrow,

but for a lifetime

For more details on classes in CPR and first aid or if you have any questions regarding training needs, call Help 4 Life on (+61) 0439 889 439, email or send me a message via my chatroom at

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