View Full Version : Compression Only CPR

04-01-2008, 16:38

NEW YORK - You can skip the mouth-to-mouth breathing and just press on the chest to save a life. In a major change, the American Heart Association said Monday that hands-only CPR rapid, deep presses on the victim's chest until help arrives works just as well as standard CPR for sudden cardiac arrest in adults.

Experts hope bystanders will now be more willing to jump in and help if they see someone suddenly collapse. Hands-only CPR is simpler and easier to remember and removes a big barrier for people skittish about the mouth-to-mouth breathing.

"You only have to do two things. Call 911 and push hard and fast on the middle of the person's chest," said Dr. Michael Sayre, an emergency medicine professor at Ohio State University who headed the committee that made the recommendation.

Hands-only CPR calls for uninterrupted chest presses 100 a minute until paramedics take over or an automated external defibrillator is available to restore a normal heart rhythm.

This action should be taken only for adults who unexpectedly collapse, stop breathing and are unresponsive. The odds are that the person is having cardiac arrest the heart suddenly stops which can occur after a heart attack or be caused by other heart problems. In such a case, the victim still has ample air in the lungs and blood and compressions keep blood flowing to the brain, heart and other organs.

A child who collapses is more likely to primarily have breathing problems and in that case, mouth-to-mouth breathing should be used. That also applies to adults who suffer lack of oxygen from a near-drowning, drug overdose, or carbon monoxide poisoning. In these cases, people need mouth-to-mouth to get air into their lungs and bloodstream.

But in either case, "Something is better than nothing," Sayre said.

The CPR guidelines had been inching toward compression-only. The last update, in 2005, put more emphasis on chest pushes by alternating 30 presses with two quick breaths; those "unable or unwilling" to do the breaths could do presses alone.

Now the heart association has given equal standing to hands-only CPR. Those who have been trained in traditional cardiopulmonary resuscitation can still opt to use it.

Sayre said the association took the unusual step of making the changes now the next update wasn't due until 2010 because three studies last year showed hands-only was as good as traditional CPR. Hands-only will be added to CPR training.

An estimated 310,000 Americans die each year of cardiac arrest outside hospitals or in emergency rooms. Only about 6 percent of those who are stricken outside a hospital survive, although rates vary by location. People who quickly get CPR while awaiting medical treatment have double or triple the chance of surviving. But less than a third of victims get this essential help.

Dr. Gordon Ewy, who's been pushing for hands-only CPR for 15 years, said he was "dancing in the streets" over the heart association's change even though he doesn't think it goes far enough. Ewy (pronounced AY-vee) is director of the University of Arizona Sarver Heart Center in Tucson, where the compression-only technique was pioneered.

Ewy said there's no point to giving early breaths in the case of sudden cardiac arrest, and it takes too long to stop compressions to give two breaths 16 seconds for the average person. He noted that victims often gasp periodically anyway, drawing in a little air on their own.

Anonymous surveys show that people are reluctant to do mouth-to-mouth, Ewy said, partly because of fear of infections.

"When people are honest, they're not going to do it," he said. "It's not only the yuck factor."

In recent years, emergency service dispatchers have been coaching callers in hands-only CPR rather than telling them how to alternate breaths and compressions.

"They love it. It's less complicated and the outcomes are better," said Dallas emergency medical services chief Dr. Paul Pepe, who also chairs emergency medicine at the University of Texas Southwestern Medical Center.

One person who's been spreading the word about hands-only CPR is Temecula, Calif., chiropractor Jared Hjelmstad, who helped save the life of a fellow health club member in Southern California

Hjelmstad, 40, had read about it in a medical journal and used it on Garth Goodall, who collapsed while working out at their gym in February. Hjelmstad's 15-year-old son Josh called 911 in the meantime.

Hjelmstad said he pumped on Goodall's chest for more than 12 minutes encouraged by Goodall's intermittent gasps until paramedics arrived. He was thrilled to find out the next day that Goodall had survived.

On Sunday, he visited Goodall in the hospital where he is recovering from triple bypass surgery.

"After this whole thing happened, I was on cloud nine," said Hjelmstad. "I was just fortunate enough to be there."

Goodall, a 49-year-old construction contractor, said he had been healthy and fit before the collapse, and there'd been no hint that he had clogged heart arteries.

"I was lucky," he said. Had the situation been reversed, "I wouldn't have known what to do."

"It's a second lease on life," he added.

04-01-2008, 19:45
Just read about the changes this morning. Wondering how long til the next round of different standards are issued.


Smokin Joe
04-01-2008, 22:44
EMS and the hospital here was apart of the study. They were having very good results.

I'll let Adal touch on the specifics but the stats I was recently given were incredible.

Glad, I won't have to lip lock anyone anymore.

04-04-2008, 13:34
still only you in US, the ERC have look at the data, that is don up to now, and they found nothing has change since 2005.

04-04-2008, 14:21
Our success rate has increased in Adult sudden Cardiac Arrest from 2% to 38% since we've been involved in this Demonstration. On our end it's easy. 200 compressions in two minutes, apply a Nonrebreather, get IV access, give meds and shock if we see that it is needed during a very short pause in compressions.
With the new Zoll M-series monitor we'll be using pads that allow us to have "look-through" CPR so it filters out our compression rythym and allows to see if we have a shockable state without stopping CPR.
The goals is to increase and keep coranary artery perfusion pressure up as long as possible.

Seems to be working. We are super happy to see the AHA come right out and say "no lip lock".

04-04-2008, 15:36
I agree with SOFMED that the changes will continue, I'm getting my recert next week by the American Red Cross as an Instructor Trainer and they stated they will not be teaching the new technique.

04-30-2008, 11:18
I'm a Red Cross CPR Instructor. I've had a question about this technique since I first heard of it, but couldn't find anyone who could give me an answer. When compressing the chest it stands to reason that you're compressing the lungs to some extent and causing some airflow. If O2 is available is there enough air exchange for it to do any good using this technique?

04-30-2008, 16:05
We will have to give CPR in one of our scenarios next week here at FLETC. They said not to use this new method. Only because the decision to switch over to just compressions hasn't been finalized. Is the higher success rate of just using compressions because people are reluctant to put their mouth on another person? Or is it that much better for the victim. 2% to 38% is a pretty big jump.

04-30-2008, 16:06
I can't believe I posted in Medical Pearls of Wisdom:lifter

Smokin Joe
05-01-2008, 01:37
We will have to give CPR in one of our scenarios next week here at FLETC. They said not to use this new method. Only because the decision to switch over to just compressions hasn't been finalized. Is the higher success rate of just using compressions because people are reluctant to put their mouth on another person? Or is it that much better for the victim. 2% to 38% is a pretty big jump.

I will defer to someone with more knowledge than I.... However my understanding is that the higher continuous chest compressions keep the blood pressure up and the oxygenated blood circulating for a longer period of time. This provides a longer and a higher quality of treatment until ALS can get on scene. -vs- standard CPR.

Again that is how I understand it. But I'm just a knuckledragging cop with very basic info on the matter.

05-01-2008, 13:41
Again, the changes will continue, as some panel somewhere will decide, based on some new research that "this technique" or "that technique" is by far better than what used to be called for, and we'll all have to learn something new again.

But then, there is a reason it is called "practicing" medicine. :D

Just my .02.


05-21-2008, 17:58
I just completed my CPR Instructor recert and this is what they passed on. Those of us in the medical field must continue to do 30 - 2 compressions/breaths and when teaching other medical personnel you teach it that way. The compressions only is for the lay person. The reasoning behind this is that they found that a lay person is more apt to give CPR if they do not have to do mouth to mouth. Also something I found interesting, as an Instructor I'm not permitted to teach two man CPR to a lay person. AHA certs are good for two yrs and must get any updates every six months while RC is annually.

Red Flag 1
05-21-2008, 18:12
Soooo.. the goal I guess is to go down in a casino. Everyone is watched all the time, defibs are everywhere.

This is the first time I have heard of two tiers of CPR training.

RF 1

05-25-2008, 23:04
Just got my Red Cross certification in CPR/AED. What I was led to believe was that anyone getting certified or trained in CPR (meaning, got the cool little card) by the AHA is taught 30:2, medical professionals or not. The same for the Red Cross, 30:2. However, the difference is that the AHA endorses "hands only" CPR for those untrained bystanders (without the cool little card), and is reaching out to inform people of this new method in case someone goes down and no one is CPR certified. Sort of a public service message. Posters and the like. The Red Cross does not seem to endorse this action, even by untrained bystanders. In fact, my instructor was quite put off that I would even think about asking a question pertaining to "hands only" CPR. He told me, "The AHA has their doctors, we have ours."

I may be incorrect, maybe some of the instructors could clarify for me?