When someone suddenly collapses, the most important thing is to act. Call 9-1-1, begin CPR, and use an automated external defibrillator (AED) as soon as one becomes available.
That message has not changed. However, Canada’s updated resuscitation guidance reinforces an important point that is sometimes lost in conversations about “hands-only” CPR: rescue breaths remain especially important for infants, children, and cardiac arrests caused by a breathing emergency.
Hands-only CPR can help, but it is not the whole story
Compression-only CPR is a practical option for an untrained person who witnesses an adult suddenly collapse. Chest compressions help circulate the oxygen already present in the person’s blood while emergency responders are on the way.
For a suspected adult cardiac arrest:
- Call 9-1-1 and send someone for an AED.
- Start CPR immediately.
- Apply the AED as soon as it arrives and follow its instructions.
- Continue until the person shows signs of life, trained help takes over, or you are unable to continue.
If you have not been trained or are uncertain about rescue breaths, provide continuous chest compressions and follow the instructions given by the 9-1-1 call taker. Doing something is far better than standing back because you are afraid of making a mistake.
Why children and infants are different
The Canadian edition of the 2025 CPR and Emergency Cardiovascular Care Guidelines renewed the emphasis on rescue breaths for infants and children.
Adult cardiac arrest is frequently associated with a sudden heart problem. In children and infants, however, cardiac arrest is more often the result of a breathing emergency. By the time the heart stops, much of the available oxygen may already have been used.
This means that chest compressions alone may not address the underlying oxygen shortage. CPR that combines compressions with effective rescue breaths is particularly important for children and infants.
Heart & Stroke’s updated guidance also supports 9-1-1 call takers providing instructions for rescue breaths during pediatric emergencies. If you are alone or uncertain, place the phone on speaker and follow the dispatcher’s directions.
Breaths also matter in breathing-related emergencies
Rescue breaths may be especially important when cardiac arrest follows:
- Drowning
- Choking
- A serious respiratory emergency
- An opioid-related emergency
- Other situations in which oxygen deprivation likely occurred before the heart stopped
In these circumstances, the person may have very little usable oxygen remaining. CPR with compressions and breaths can support both circulation and oxygen delivery until advanced care arrives.
What this means for workplaces and community organizations
An AED is essential, but preparedness cannot stop at purchasing equipment. Organizations should ensure that people are trained, equipment is accessible, and emergency procedures are practised.
A strong response program should include:
- Enough trained first-aid and CPR providers to cover every shift
- An AED that can be reached quickly
- Regular AED inspections and replacement of expired pads or batteries
- Clear instructions for contacting 9-1-1 and directing responders to the emergency
- Training that includes adult, child, and infant emergencies where appropriate
- Realistic practice that builds confidence in compressions, rescue breaths, and AED use
Schools, childcare settings, recreation facilities, fire departments, industrial workplaces, and community organizations should pay particular attention to pediatric CPR and breathing-related emergencies.
Training builds the confidence to act
Reading about CPR is useful, but it cannot replace hands-on practice. Quality training allows participants to practise recognizing cardiac arrest, starting CPR, delivering effective rescue breaths, using an AED, and responding when the situation does not unfold exactly as expected.
The latest Canadian guidance does not suggest that previously trained responders should hesitate while trying to remember every detail. The priorities remain straightforward: recognize the emergency, call 9-1-1, begin CPR, and use an AED as quickly as possible.
For untrained witnesses of a sudden adult collapse, compression-only CPR can save a life. For trained responders and particularly when caring for infants, children, or people affected by a breathing-related emergency, rescue breaths continue to be a vital part of CPR.
Atlantic Emergency Medical Training Solutions provides practical first-aid, CPR, AED, and emergency medical training designed to help people respond with skill and confidence. Contact AEMTS to discuss training for your workplace, organization, or community group.
This article provides general educational information and is not individualized medical advice or a substitute for recognized first-aid and CPR training. During an emergency, call 9-1-1 and follow the instructions of the emergency call taker.
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