The kiss of life may be kiss of death, say first-aid experts

The kiss of life, star of a thousand television medical soaps and the bedrock of resuscitation for decades, would be better termed the kiss of death.

The kiss of life, star of a thousand television medical soaps and the bedrock of resuscitation for decades, would be better termed the kiss of death.

Thirty years after it was introduced, research has shown that mouth-to-mouth resuscitation may be costing more lives than it saves. Pumping the chest of a victim whose heart has stopped to move the blood round the body is easier to do, less off-putting and more effective in saving lives.

Now the world's resuscitation councils, which co-ordinate practice around the globe, are considering changes to their guidelines to downgrade the role of the kiss of life. Dr Lotte Newman, medical adviser to St John Ambulance, Britain's leading first aid organisation, said: "I think this may well be the trend for the future."

The standard advice on resuscitation of a collapsed victim is to apply 15 rapid chest compressions, alternating with two breaths of the kiss of life to ventilate the lungs. The aim is to keep oxygenated blood circulating to the brain and vital organs until an ambulance arrives and efforts can be made to restart the heart with a defibrillator.

Middle-aged heart attack victims - the majority of those who collapse - have no shortage of oxygenated blood in their systems, and the priority is to keep it circulating by pumping the chest. But in children involved in an accident or rescued from drowning, mouth-to-mouth resuscitation is essential.Dr Bob Bingham, chairman of Resuscitation UK and a consultant anaesthetist at Great Ormond Street Hospital, London, said: "If you just did chest compressions fewer children would be saved although more lives might be saved."

A study in Seattle, in the United States, in which bystanders at the scene of someone who had collapsed were advised by the emergency services over the telephone either to perform chest compressions alone or chest compressions combined with the kiss of life found that pumping the chest alone was most effective.An editorial in The New England Journal of Medicine, which published the study in May, said the findings had "worldwide implications". It quoted a remark by one of the bystanders in the Seattle study who said: "Why is it every time I press on his chest he opens his eyes and every time I stop to breathe for him he goes back to sleep?"

The advantage of chest compressions alone is that they are easier and do not require mouth-to-mouth contact with a stranger. In one survey, just 15 per cent of people said they would definitely give the kiss of life to a strangercompared with 68 per cent who said they would perform chest compressions.