Experts Now Recommend Hands-Only CPR
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.
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On the Net: Taken from an article found on Comcast Front Page
Heart Association: http://www.americanheart.org/handsonlycpr
Sarver Heart Center: http://www.heart.arizona.edu/