CPR Breaths or No Breaths

[GTF425]

One of the hurdles to getting more bystander CPR was aversion to ventilations.

Ventilations haven't gone away, they are just made optional/deemphasized by training product. Anyone that says otherwise is wrong.

Another factor in this is access time.

...the longer you're doing even good CPR the lower chances of survival are.

Quoting the above for absolute truth. Great post and the bullet points above are why you see such a widespread adoption of "hands-only" CPR being taught to laypeople.

The 2 biggest factors to surviving (adult) pre-hospital cardiac arrest are downtime to CPR and early defibrillation if appropriate. Time is muscle, and your brain tissue will begin to die after roughly 5 minutes without blood circulating to exchange oxygen for the waste products of metabolism. Performance-wise, the most significant things are to ensure that compressions are at an adequate depth (you can feel a carotid pulse when someone is performing chest compressions if you're unsure if they are deep enough. This is usually a problem with bystander CPR or with infants) and that the chest is allowed to fully recoil. We naturally ventilate through negative pressure; by allowing the chest to fully recoil, we not only provide time for the chambers of the heart to fill with blood, but we also allow our lungs to fill to their functional residual volume with room air. While this is obviously not the same volume as ventilating, it is sufficient for gas exchange in the lungs and is part of why you'll see some environments push for passive oxygenation without interrupting chest compressions.

Great posts in this thread.