Recent news has been filled with information about the changes in CPR. No more rescue breathing; only chest compressions! Although most of this is true, this is only part of the story. This article is aimed at clarifying and demystifying the new 2010 CPR Guidelines. Studies on the subject of CPR have been going on ...

Recent news has been filled with information about the changes in CPR. No more rescue breathing; only chest compressions! Although most of this is true, this is only part of the story. This article is aimed at clarifying and demystifying the new 2010 CPR Guidelines.

Studies on the subject of CPR have been going on for many years. In fact, 2010 marked the 50th anniversary of CPR. This was an achievement that was celebrated in San Diego, California in December, 2010 while at the same time, introducing the science behind the new guideline changes.

The History of CPR

Artificial respiration (i.e. mouth to mouth) was used in the 18th century as a preferred resuscitation technique. Years later, in 1950 Dr. Kowenhover discovered that pressing hard on the chest using defibrillator paddles forced blood to flow from the heart throughout the body. This discovery proved that artificially forcing down the chest was an effective and safe technique of resuscitation rather than the previous method which involved surgically opening the chest cavity and massaging the heart by hand. These new findings led to hospitals developing a new, revolutionary procedure for cases when a patient was on the operating table and went into ventricular fibrillation. Nurses would be placed on standby to apply a combined ventilation and compression technique which proved to be surprisingly effective.

In September, 1960, history was made at a conference in Maryland. The Doctors Kowenhover, Safer and Jude presented the case that by combining the two methods of artificial respiration with chest compressions, lives were changed. No longer would an individual have to helplessly stand by and watch as a cardiac arrest victim died. Precious time and precious lives could be saved by providing chest compressions and artificial respirations until advanced medical assistance became available. This produced a truly effective and proactive approach to the present methods of resuscitation.

The Baltimore fire department was the first to take this technique to the field by training all their fire fighters. Once this method was proven in the field, Doctors Kowenhover, Safer and Jude devoted themselves to promoting this technique to the public. In 1962, The American Heart Association coined the term CPR for this life-saving procedure.

Compliments of the Canadian Red Cross and YouTube

Why the Change?

The 2010 American Heart Association Guidelines for CPR and ECC have produced some further improvements to the technique of CPR. The word “quality CPR” shows up 143 times in this manual and is a main focus of the new standards. The 2010 CPR Guidelines are designed to improve the quality of CPR compressions while minimizing interruptions. Good CPR chest compressions are a direct link to survival.

In 2006, studies showed that 69% of cardiovascular incidents happened at home and of that, 37% of the people either did not know what to do, did not respond well or they did not perform CPR effectively. Shockingly, studies also found that even when individuals were trained, they would not perform CPR. Why would these bystanders not perform CPR even when they have been trained? There are several reasons for this which include the following:

• The individuals may not have been properly trained
• They may not be prepared to deal with a panic situation
• They are concerned about infections that may be spread through mouth to mouth respiration

By reducing these psychological and physical barriers and by having bystanders recognize an emergency and starting CPR is the goal of the new 2010 CPR Guidelines. If someone panics while trying to help, they may become more of a hindrance than help in the rescue attempt. This is why it is extremely important to have a commitment to rehearsals or role play scenarios when training individuals in First Aid and CPR. One study shows that during stressful situations, the heart rates of individuals can rise to above 170 beats/minute. The simple task of dialling 9-1-1 on an unfamiliar phone could be a challenge in such a situation. Many times, the person does not press the send button on a cell phone or presses variations of X-1-1. Even practicing the simple task of calling 9-1-1 during a non-stressful period is beneficial. If an emergency situation happens and one can revert to his/her training, these tasks become routine.

Nevertheless, no matter how well one is trained in emergency situations, the event is never exactly what one has expected or practiced for. A well trained person will probably manage successfully if they understand their role, decide to act, take control, overcome their fears and do what they have been trained to do to the best of their ability. There are some fundamental steps that a rescuer should use in any emergency situation. He/she should:

• Recognize that an emergency situation exists
• Initiate the EMS system by calling 9-1-1 and getting help
• Follow an emergency action plan
• If required, commence with chest compressions.

The key issue of the new 2010 CPR Guidelines is to be able to get bystanders to perform CPR thereby increasing the chances of survival of the casualty. Compression only CPR effectively attains its goal which is to move oxygenated blood to the vital organs, while eliminating the fears of a would-be rescuer. It therefore increases the probability of a lay person performing CPR in an emergency situation.

Compliments of the University of Arizona Sarver Heart Center and YouTube

2010 CPR Guideline Synopsis

Here are the steps that the 2010 CPR Guidelines have laid out. If a person has been witnessed to collapse due to a cardiac arrest, there is still an adequate supply of oxygen in his/her blood. The rescuer should have another bystander call EMS 9-1-1 and bring back an AED. The goal of the rescuer is now to move the blood to where it is needed most to keep this person alive. This is done by continual chest compressions by placing the heel of one hand in the center of the chest between the nipple line, while putting the other hand on top of the first and pushing straight down on the chest at least two inches. After each compression, the chest must be allowed to fully recoil before pushing down again. This should be done at a rate of 100 compressions a minute. A good gauge to is to press the chest down in time to the Bee Gees’ song “Stayin’ Alive”.

Emergency services teams are very capable of being able to effectively talk a rescuer through the steps of performing CPR. This is when a compressions only CPR situation is ideal. The bystander commences with continual chest compressions until relieved by someone of an equal or higher level of training. On January 4, 2011, I received a phone call from one of our clients who asked for a first aid manual to given to his niece who had never taken a First Aid or CPR class. A few days prior to this call, his niece was at home and saw that her mother lying on the bed. Her mother had bluish skin and did not appear to be breathing. She immediately called 9-1-1 and the dispatcher talked her through performing chest compressions and stayed on the phone with her until the paramedics arrived. Her mother is now doing well and is out of the hospital. This young woman saved her mother’s life by doing compression only CPR without prior training. She has been nominated for a Rescuers’ Award.

Compliments of the University of Arizona Sarver Heart Centre and YouTube

The new 2010 CPR Guidelines bring much to the table. They offer individuals the ability to assist in an emergency situation by using compressions only CPR with minimal fear. The psychological and physical barriers barring one from performing CPR have been now been minimized and therefore, and most importantly, the chances of survival for a casualty has been greatly increased as a result.

Sources

• Canadian Red Cross
• The University of Arizona Sarver Heart Center
• The Arizona Department of Health Services
• San Diego ECCU Conference 2010
• YouTube

This information is offered as information only and is designed to promote Health & Safety in the workplace and the community. It is subject to change.