To Breathe or Not to Breathe

As an electrician it is a requirement to maintain currency with low voltage rescue (LVR) and CPR.  The most common statement I get from students regarding CPR during Capstone is “no breaths, breathing is out, there is no requirement”.  On several occasions I have been told “the casualty’s brain can be over oxygenated if you use breaths”, really?  Your breath has less oxygen after you have used it, think about it.  So the question is do we breathe or do we not breathe.

This blog is in the context of Capstone; that is, for apprentices and tradespeople in the electrical field.  One component of Capstone is CPR and you are likely to get examined on this subject so where there is contention I usually go to the Unit of Competency in question which in Australia is HLTAID001 Provide Cardiopulmonary Resuscitation.  The unit states in its application (pg 2)  –  “This unit describes the skills and knowledge required to perform cardiopulmonary resuscitation (CPR) in line with the Australian Resuscitation Council (ARC) Guidelines”.  So there it is, the unit directs you to the ARC.

Look in the ARC guidelines you will find that they state:

·        The ratio of compressions to rescue breaths is 30:2.

·        Mouth to mouth, mouth to nose, and mouth to mask are all viable methods of rescue breathing. Mouth to stoma should be used where a person has had a laryngectomy.

·        Risk of disease transmission is very low and rescuers need not be deterred from providing rescue breaths without a barrier device. However, rescuers should consider using a barrier device if this is available.

·        Those who are trained and willing to give rescue breaths do so for all persons who are unresponsive and not breathing normally. Normal breathing is essential to maintaining life.

 Are compressions better than nothing?

The general consensus is that if you are not willing to risk getting a disease from giving rescue breathes, then performing compressions only is better that no first aid assistance at all, true I agree.  However for us as electricians we should be looking at CPR in the context for LVR purposes.  That is, if you are a safety observer then this is because an electrician is doing work that is a high risk, your primary job is to make sure they do not do anything that further endangers them and your secondary purpose is to rescue them and give first aid.  I don’t know about you but if I was the one getting rescued I would want the best possible attention for my own survival and that includes rescue breathes.

Planning is everything. 

In a situation where the risk is high, a risk analysis is required and as part of that analysis I would be checking with the safety observer regarding their emergency procedure.  If there is a reluctance to perform breathes then I would insist on the additional control measure of a mouth to mouth mask or something similar and noting that in the written risk assessment.  If this is still not acceptable to the safety observer then I would (politely) find another observer.

Summary

If I was walking down the street and found myself in a situation where I do not know the person, sure I would perform compressions only.  If this was for a planned electrical job I would insist on the best preparedness possible which includes giving breaths and as part of that preparation include a mask (to protect both parties).  We hear a lot of conflicting suggestions for what we should or could do, do yourself a favour and look at the requirements that suit your situation, the safety observer and the electrician doing the work need to have a conversation, have a look at the ARC Guidelines and you make up your own mind.

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