LOS ANGELES TIMES (LT) - TUESDAY October 20, 1987
Allan Parachini; Times Staff Writer

The results of the survey raises this question: Is it safe for a lay rescuer to do CPR--which involves mouth-to-mouth contact--on someone known or suspected to have AIDS or to be infected by Human Immunodeficiency Virus (HIV)?

'Probably' Safe

The consensus among AIDS and emergency medical services experts across the country is that the rescuer "probably" is safe--for reasons that may have as much to do with the low cardiac risk profile of AIDS patients as anything else. AIDS patients are generally young enough that they probably do not suffer heart and respiratory failure in great numbers outside of hospitals.

But it is indicative of the continuing volatility of the crisis that an official of the UC San Francisco AIDS task force declined to say if he himself would administer CPR to an AIDS patient if he did not have access to such safety equipment as the breathing bags commonly found in hospitals and in ambulances and emergency vehicles.

"I would recommend that (a rescuer) use a protective device," said Dr. W. Keith Hadley of San Francisco General Hospital.

But if such equipment--which makes it unnecessary for the rescuer to maintain actual mouth contact with the victim--is unavailable, as would be common in citizen CPR, Hadley said, "that's something that is a decision by the individual." Would he do it himself with no safety equipment at hand? "I don't care to answer that," Hadley said.

Officially, the federal Centers for Disease Control in Atlanta recommended through a spokesman that anyone needing CPR should be given it by qualified rescuers. CDC studies, the spokesman said, indicate "it is highly unlikely" that a CPR rescuer could get the AIDS virus from the saliva, blood or vomit of a patient.

The issue was raised in an article in the journal Annals of Emergency Medicine reporting results of a survey of more than 700 Orange County CPR trainees who were questioned by UC Irvine Medical Center researchers. A total of 67.7% said they would not perform CPR on someone they knew had AIDS; 55.4% said they would not do it on anyone "suspected" of having AIDS. On the other hand, 92.2% said they would do CPR on a stranger not thought to have AIDS, and 77.5% thought CPR should be performed on the terminally ill.

Dr. Gregg Pane, who headed the project, said the volunteers' fears were understandable, but added, "I think the balance of evidence is the chance of (contracting AIDS in CPR) are minimal or nonexistent." However, Pane said, "you can never give a 100% answer. I guess that it's kind of a moral (decision) for every individual to make at the scene. I would say that in my judgment, yes, it is safe, but it's your own personal judgment if you encounter such a situation."

Dr. Bruce Haynes, director of the California Emergency Medical Services Authority, said that while AIDS experts initially concluded the virus could not be spread through the contact that occurs in CPR, the certainty has given way to at least an element of doubt. The far greater danger, Haynes contended, is that irrational fear of AIDS could make trained citizen volunteers unduly afraid to use skills that could save lives.

"I don't know what I'd do," if faced with the decision personally, Haynes conceded. "I haven't really been confronted with that."

The medical literature on AIDS contains several studies concluding there is little or no risk in CPR performed by professional rescuers or in hospitals --provided safety equipment is used--and that CPR training dummies are not capable of transmitting the disease. But the question of whether CPR can safely be performed by lay people in typical emergency settings--sidewalks, office buildings and bedrooms--has, surprisingly, not been specifically addressed. Studies of CPR have shown it most often occurs in the homes of comparatively elderly heart attack victims. Family members are the most frequent successful rescuers.
871020
LT871001

Always watch for outdated information. This article first appeared in 1987. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1987. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .