Do You CPR?

Summarized by Robert W. Griffith, MD
December 19, 2005

Introduction

Many non-health professionals have taken CPR courses, and never had to use it. Not all of them have kept up-to-date with refresher courses. And still more people haven't ever learned CPR, or cardiopulmonary resuscitation (though they've seen enough of it on TV programs like "E.R." and "Gray's Anatomy"). Now small but important changes have been made in the 2005 American Heart Association Guidelines for CPR, and they have been published online (see Source, below). It's a good time for lay people to refresh their knowledge of CPR, and learn about the changes that have been made, based on survival rates from numerous clinical studies. This is a short summary of the main features of the guidelines for lay persons dealing with adult cardiac arrest victims; they are certainly no substitute for a certified CPR training course or refresher course. The more people who can perform CPR, the more lives will be saved.

More than 300,000 Americans die from cardiac arrest each year, with about 75% to 80% of cases outside a hospital occurring at home. Effective CPR can double the chances of survival.

The important new differences

The new guidelines emphasize chest compressions instead of mouth-to-mouth resuscitation; what's important is to keep the blood flowing. They recommend 30 compressions (instead of 15) for every two rescue breaths. And one shouldn't pause to check for improvement.

The guidelines also aim for simplification. Lay rescuers shouldn't check for a pulse or signs of circulation in an unresponsive victim.

The New ABC

These abbreviated instructions are for a lay person treating an adult, only.
Airway: tilt the head back, lift the chin.

Breathing: give two mouth-to-mouth breaths, at 1 second/breath. If there's foreign-body airway obstruction, perform abdominal thrusts (like a Heimlich maneuver).

Circulation:chest compressions, hard and fast, to a depth of 1½ to 2 inches. Use the heel of one hand, other hand on top, on the lower half of the sternum at the nipple line. Rate about 100/minute. After 30 compressions, repeat 2 rescue breaths, then 30 more compressions, and so on.

Defibrillation: If a defibrillator is available, give one shock before starting chest compressions. Then check the heart rhythm after 2 minutes (about 5 CPR cycles).

Conclusions

More than 90% of cardiac arrest victims die before they get to hospital. The most important factor for survival is the presence of someone who is trained, willing, and able to act in this emergency. Clearly, more people need to learn CPR. Currently, about 9 million Americans are trained each year according to the AHA; the goal is to double that number in the next five years. If you haven't learned CPR, why not sign up for a training course? And if you have done the course, make sure that you take a short refresher course. You never know when you may be able to save a life!

Source

• American Heart Association 2005 Guidelines for CPR, posted online by Circulation, at: http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.105.166552v1, accessed on 12/4/04

Related Links
Find a CPR Class Near You
How CPR Works
CPR: I Need To Know

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