NHS says you should perform rescue breaths on children who aren’t breathing

Following the collapse of footballer Christian Eriksen during a recent Euro 2020 match between Denmark and Finland, social media users have been sharing information on how to perform Cardiopulmonary Resuscitation (CPR), a potentially life saving intervention for somebody in cardiac arrest. 

One widely shared post talks about the importance of CPR and shows an infographic (which may have been taken from a Medical News Today article) of how to do chest compressions on people in different age groups. 

This illustration and caption regarding CPR for children appears to differ from the UK guidance. It’s always worth double checking health and medical advice shared on social media with official sources like the NHS website.  

CPR education, guideline and policy charity Resuscitation Council UK advice states that if a child is not breathing or has abnormal breathing, rescue breaths (mouth to mouth) should be given prior to and during CPR. After being approached by Full Fact, the NHS also updated its online advice to stress the importance of rescue breaths for children.

During the Covid-19 pandemic, in adults, if there is a perceived risk of Covid-19 infection the advice is to do compression only CPR. 

For children, however, Resuscitation Council UK has said: “It is likely that the child/infant having an out-of-hospital cardiac arrest will be known to you. We accept that doing rescue breaths will increase the risk of transmitting the COVID-19 virus, either to the rescuer or the child/infant. However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.”

Sue Hampshire, the organisation’s Director of Clinical and Service Development told Full Fact: “A cardiac arrest in a child is very rarely due to a cardiac cause. It is most likely to be the result of progressive deterioration, and primarily be due to a respiratory cause resulting in the cardiac arrest. So providing the child with oxygen through rescue breaths is of prime importance.”

Resuscitation Council UK also said that their paediatric resuscitation guidelines suggest a ratio of chest compressions to rescue breaths of 15:2 for children but said that often 30:2 is taught (as is on the NHS website) for both adults and children for simplicity and ease of remembering. It told us, if in doubt, to start with what you know and once on the phone to the ambulance dispatcher, take advice from them.

It also told Full Fact that most recommendations say that “it is better to provide both [chest compressions] and [rescue breaths] but that [chest compressions] alone should be done if the rescuer is unable to do [rescue breaths].”

The International Liaison Committee on Resuscitation has said that “if bystanders can’t provide rescue breaths as part of CPR for infants and children younger than 18 years with [out of hospital cardiac arrest]...they should at least provide chest compressions.”

For adults, the NHS advises people only perform rescue breaths if they are completely confident doing so.

For more information about resuscitation visit the Resuscitation Council UK website.