Could Carrying a Handkerchief Help Save a Life?

A recent study performed by a collection of Japanese researchers at two Tokyo-based universities, Chuo University & Kokushikan University, in specialties ranging from Integrated Science and Engineering for Sustainable Society to Disaster Management & Emergency Medical Systems, asked the question: 


Can handkerchiefs be suitable for mouth-to-mouth ventilation?


In the event of an emergency in which CPR would need to be administered, mouth-to-mouth ventilation is, of course, a necessary component. As it is taught, a CPR mask or face shield is used to create a physical barrier between the victim and the trained professional. The purpose of the mask being to prevent the transmission of illnesses while still allowing for air to pass into the victim.

These types of masks are ideal in settings such as hospitals, pools, or beaches where such lifesaving equipment is readily on hand, however many peopleeven those trained in CPRdo not walk around with face shields in their daily lives.



This is a problem because the random onset of cardiac events makes for a high probability of someone not having their mask on them should a situation arise in which they would need to perform CPR.

On the other hand, handkerchiefs are a common everyday accessory used by millions, if not billions, of people around the world, especially in Japan.

Therefore, researchers sought to know how handkerchiefs would fare as a CPR mask replacement. The benefit being, if they performed well, it would greatly increase the availability of trained individuals to safely administer mouth-to-mouth ventilation.

 CPR Mask



To perform the test, the experimenters equipped a manikin with a device capable of measuring the inflow ventilation volume. Next, they collected handkerchiefs of various weave patterns and fabrics to act as makeshift face shields and measured their inflow results against those of a standard CPR mask. 

Test Groups:

1. Plain weave (how our handkerchiefs would be characterized

2. Twill weave

3. Satin weave (pocket square material)

4. CPR mask/face shield (control group

The differences in mean ventilation volumes were then analyzed using multiple statistical methods including one-way analysis of variance and Tukey’s multiple test.



According to the results, there was no difference between the mean inflow ventilation volume transmitted by the plain and twill weave handkerchiefs and the CPR mask. Plain weave handkerchiefs even outperformed face shields when the yarn count was at or below 250.

In other words, the handkerchiefs performed just as well, if not better than, the CPR mask in administering mouth-to-mouth ventilation. 

That is amazing!

Even further, the average ventilation volume of the satin weave handkerchief was actually significantly higher than that of the CPR mask  meaning the satin handkerchief (pocket square material) was the best for delivering rescue breaths. 


"This suggests that some handkerchiefs may be similarly or more effective for ventilation than a face shield."




This is great news! 

Wherever we go, we can feel a little bit better knowing that whatever happens, we'll be prepared  even in an emergency. Chalk it up as yet another potential use for handkerchiefs. 

And being that air travels through linen at 4X the speed of cotton, it is likely that our handkerchiefs would perform even better than the results obtained in the study.

This is because linen is both more porous (increased air flow) and thicker (better barrier) than most other textiles. 





Nomoto, Soichiro, et al. “Can Handkerchiefs Be Suitable for Mouth-to-Mouth Ventilation?” Resuscitation, vol. 142, Sept. 2019, pp. e54–55., doi:10.1016/j.resuscitation.2019.06.130.