Question: What is the Best Type of CPR Mask for Giving Mouth-to-Mouth?
A reader in About.com's First Aid Forum asks about the best type of CPR mask a lay rescuer should use when doing mouth-to-mouth. He is concerned that a barrier device, supplied with an AED he and his wife purchased for their home, would be difficult to use. He asks if one of the many other products available would be better for him and his wife to use, should they need to perform CPR.
Answer: First, it's important to realize that a CPR mask, officially known as a barrier device, is for keeping you -- the rescuer -- safe. It doesn't make rescue breaths more effective than straight mouth-to-mouth.
For an intimate partner or immediate family member, a barrier device is probably not necessary unless the victim is known to have an infectious disease. It's probably not even necessary for performing mouth-to-mouth on a stranger in the grocery store, but we'll get to that in a moment.
Different Types of Barrier Devices
A barrier device is one type of personal protective equipment designed to protect rescuers from exposure to infection when in close contact with victims. HIV and the hepatitis family of viruses are carried in blood and some other body fluids. Since there is no way to know if the victim of a cardiac arrest is carrying these or any other communicable diseases, it's wise to use a barrier device to keep body fluids out of the rescuer's mouth during rescue breathing.
There are 2 types of barrier devices used by lay rescuers:
- A flat plastic barrier that lays across the victim's mouth and nose. It conforms to the face and allows the rescuer to blow through a hole in the middle. The hole has either a one-way valve or a filter to protect the rescuer, depending on the brand. These flat barriers are popular with lay rescuers (and off-duty professionals) because they are so portable. Most of the time, they can fold up tight and fit on a keychain.
- A mask shaped like a pear that fits over the mouth and nose. With proper technique, it seals around the mouth and nose. The rescuer blows through a one-way valve at the top to provide rescue breaths.
To an untrained eye, these can look like complicated devices. For most lay rescuers, a flat barrier is probably the best device on the market because of its ease of use and portability. The technique required for making a seal with mask devices is difficult to learn and very hard to perfect.
Barrier or No Barrier? That Is the Question
Not having a barrier -- or not knowing exactly how to use one -- shouldn't keep you from performing CPR.
There is a growing body of evidence that removing mouth-to-mouth from CPR and only pushing on the chest is enough to revive a cardiac arrest victim -- maybe even better than combining chest compressions with rescue breathing. Currently, if you call 911 and the dispatcher walks you through the steps for CPR, he or she will not ask you to give rescue breaths until you've done 400 compressions. And the dispatcher will not care if you have a barrier device.
This means that if you find a stranger lying unconscious and not breathing in the middle of aisle 4 in the grocery store, you should have someone call 911 and start chest compressions, even if you don't have a barrier device at the ready.
If the person down is a family member, then you probably don't need a barrier device at all. It stands to reason that if you are willing to kiss a person, then you are able to give rescue breaths without a barrier device. Time is certainly of the essence, and searching the catch-all drawer for a mask or the car keys with the barrier device attached is not keeping blood flowing to the heart and brain.
No Substitute for Training
All of this assumes you have actually taken a CPR class. It's a good idea to get the proper training for CPR and for whatever AED you may be expected to use. That means that if you have an AED at work, home or school, train on that model. Likewise, you should get the training to properly use whichever barrier device you are most likely to have available during an emergency.
Barrier devices make it safe to perform CPR on a stranger. They even make CPR less intimate and more comfortable to perform on a loved one. Despite their functionality, barrier devices aren't necessary to do good CPR.
When in doubt, call 911 and start pumping the victim's chest. Push hard, and push fast.
Ewy, GA, et al."Cardiocerebral resuscitation for cardiac arrest." Am J Med. Jan 2006.
SOS-KANTO Study Group. "Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study." The Lancet. 17 Mar 2007.