EMS provider reluctance to perform mouth-to-mouth resuscitation

To assess the willingness of EMS providers to perform mouth-to-mouth resuscitation (MMR) both with and without a barrier device (e.g., face shield), while not on duty; and to determine the providers' perceived risk from performing MMR and the frequency with which they carry a barrier device.

A survey was mailed to 543 EMS providers presenting four scenarios describing a patient in respiratory arrest. The respondents were asked whether they would perform MMR in each scenario both with and without a barrier device.

Of those surveyed, 342 (64%) responded. Strikingly few (< or =5%) of the respondents would perform MMR without a barrier on each of the cases, except for the case of a pediatric drowning (52%). The respondents were least likely to perform MMR on a patient with AIDS (< 1%). The respondents were much more likely to perform MMR in each case if a barrier device was available. The respondents were very concerned about the risk of contagion from MMR, yet 44% of the respondents rarely or never carried a barrier device with them.

Emergency medical services providers are quite reluctant to perform MMR, and this is likely related to their perception of a high risk of contagion. The availability of barrier devices greatly decreases this reluctance, but EMS personnel carry such devices infrequently.