Mouth-to-mouth resuscitation can save a life.

But in the era of covid-19, it can also put lives at risk.

That’s the odd dilemma faced by people who respond to drownings. Giving the air that is so necessary to drowning victims could also result in the transmission of the coronavirus.

Now, an international group of resuscitation and drowning experts has weighed in on how to safely revive a drowned person.

In a consensus statement published in JAMA Network Open, the group laid out guidelines for safe ventilation.

The working group formed swiftly after the pandemic began, recognizing that even more lives were at risk if no safe form of resuscitation was found and publicized.

The researchers are suggesting ways to mitigate the inherent risk of infection that rescuers face. They recommend that facilities and groups think about how their users protect themselves during the pandemic as a way to assess risk, and keep people from high-risk groups from assignments that include direct contact with swimmers.

Designated rescuers should be among the first to be fully vaccinated and get the same kind of testing access available to first responders, they say. Rescues should include personal protective equipment: gloves, face mask, eye protection.

When it comes to the rescues themselves, bag valve masks, in which air is pumped into the lungs using a balloon-like bag, are recommended.

Mouth-to-mouth resuscitation should be avoided, and rescuers who don’t have access to PPE should encourage trained family members to provide it when possible.

There’s one exception: children. If no PPE is available, the panel recommends that rescuers do mouth-to-mouth anyway.

Ultimately, the panel writes, “Organizations and employers have an ethical obligation to act in the interest of the rescuer’s safety.”

Better PPE, robust training and the development of more equipment that’s suited to a watery environment can keep rescuers and the public as safe as possible, they say.

Resuscitation of Drowned Persons During the COVID-19 Pandemic

JAMA Network Open