Cardiopulmonary Resuscitation— Potential Danger of Cross-Infection

To the Editor.—  Cardiopulmonary resuscitation (CPR) training is conducted with the aid of a manikin using the guidelines of the American Heart Association.¹ The procedure entails mouth-to-mouth breathing and cardiac compression, performed either as a single-person or as a twoperson effort. The latter requires frequent switching of roles by the two "rescuers" from breathing to cardiac compression without allowing time to clean the manikin's oral surface. Thus, the contamination of manikins by saliva poses a potential threat of infection. In a previous report, the Center for Disease Control² indicated that the chances of transmitting hepatitis via manikins contaminated with hepatitis B surface antigenpositive saliva were remote.We address ourselves to the potential danger of bacterial infection during a CPR training session. The initial study consisted of 30 physicians and six instructors (six persons to a manikin). Cultures taken from the manikin lips at the conclusion of the CPR