On October 18, 2010 the American Heart Association (AHA) released the newest guidelines for performing Cardiopulmonary Resuscitation more commonly referred to as CPR. They do this every five year based on new studies and clinical evidence supporting change. With every release of the guidelines the American Heart Association and the medical community make it easier to remember and perform this life saving task and this newest release is no exception.
CPR is performed on someone who is in Sudden Cardiac Arrest (SCA). Sudden Cardiac Arrest is when someone's heart stops beating and pushing blood through the body. When someone falls victim of SCA they are clinically dead. It has long been known that performing CPR can help sustain the body long enough to get a defibrillator to shock the heart back to normal and hopefully bring this person back to life.
Each year we lose more than 300,000 people in the United States to this deadly event. This is more than all major forms of cancer combined. It is the largest killer of women in the U.S. and we lose between 3,000 and 7,000 children from it every year.
If you have ever taken a course in CPR you were taught to open the Airway by tilting the head back and lifting the chin. Check for Breathing by the "look, listen, and feel" method where you looked for chest rise, listened with your ear close to the victims mouth and nose and felt for any type of breath that might tickle your skin. Next, if breathing was absent, you were taught to perform chest Compressions by placing the heal of one hand over the victims chest, placing the heal of your other hand on top of the first and compressing the chest approximately 1½ to 2 inches at a rate of 100 compressions per minute. This was commonly referred to as the ABC's of life. Now the AHA wants you to focus more on the C's or Compressions.
For the past two years, instructors who teach CPR around the world have been able to talk about and demonstrate a new way of performing CPR called "Hands-Only" CPR. This method of performing compressions eliminates the steps of opening the airway, checking for breathing and then performing compressions. With the Hands-Only method you simply square up over the victims chest and start compressing hard and fast and don't stop until help arrives.
The thinking around this new method is supported by two facts. First, it is understood that the blood in the system has a residual amount of oxygen that can sustain life for 8 to 10 minutes. By compressing the chest continuously you build up an internal pressure that helps draw ambient air into the system and move blood more efficiently through the body. This life saving blood is what helps keep the victim's heart and brain viable until more advanced therapies can be performed by paramedics and emergency medical staff. Also it has been proven through research that continuous chest compressions with as little interruption as possible helps save more lives that chest compressions interrupted by breathing.
The second reason for this change is simply referred to as the "ick" factor. No one wants to put their mouth on a strangers face and blow. The fact is that only about one third of victims of sudden cardiac arrest receive CPR is because people are afraid to do this part of the process. By eliminating this part of the process, experts believe that more people will do something and more people will survive.
Now after several years of research and field experience, the newest Guidelines released this month have changed the way we are going to look at and teach CPR. Instead of the ABC's of life we are now going to teach and perform the CAB's of life. I know it's not as sexy an acronym but placing the Compressions first in the sequence will lead to better outcomes and hopefully encourage more people to take action and help save more lives.
In a recent web article from Shine magazine, author Jessica Ashley pointed out 5 potentially life-saving notes to remember about the new C-A-B method of CPR and these five things bear repeating here. First, there are no mistakes when you perform CPR. What most people don't know is that there is virtually nothing you can do to harm a victim of sudden cardiac arrest. By doing something you are doing more than if you were doing nothing. Second, all victims of sudden cardiac arrest need chest compressions. The AHA believes that performing chest compressions first helps push vital blood through the body to support the brain and heart thereby saving vital seconds that used to be lost while a rescuer looks, listens, and feels for breathing.
In all of my classes I ask a simple question. "Who do you think is the person who will have a heart attack and die?" Almost unanimously the answer comes back as the old, fat guy that sits around all day watching T.V. with a beer in one hand, a fast food burger in the other, a cigarette in the ash tray. So Ms. Ashley smartly points out in her third fact that it's a myth that this group is the only one at risk for a heart attack. If you look at national statistics you would be surprised how many younger, fit, and healthy people are dying each year from sudden cardiac arrest.
The fourth point I think is the most important. Nearly all cardiac emergencies occur in the home. It is a statistical fact that 80% of sudden cardiac arrest happen in the home. If you ever perform CPR it will most likely be in your home on someone you love. This point alone makes it more important for everyone to learn how to call 9-1-1, perform CPR and possibly even have a defibrillator in their home. Speed is of the essence here and time is precious.
And finally the fifth point worth mentioning is that training is simpler and more accessible than you think. Placing your hands on the chest and pushing hard and fast is not difficult to do and easy to learn. People who have never been trained in CPR have performed this simple step and helped save a life. Learning CPR from an online program or better yet, from an instructor in a class, is inexpensive, easy, and fulfilling. So remember, Compressions first, airway and breathing second. If you haven't been trained to manage the airway and breathe for the victim or you just don't feel comfortable just do the compressions until help arrives.
About the author: Richard Bilger is a resident of Walker, Minnesota and a volunteer with the LakePort Area First Responders. He has spent the last 25 years concentrating on the emergency medical services profession with a focus on education and early defibrillation. Richard, along with his wife Corina, has taught hundreds of people to perform CPR through their local CPR training business.
