Recently the American Heart Association introduced 2 major changes in the way CPR is being taught and being done.

Hands Only

Hands-only CPR is a technique that involves simply using chest compressions on an individual who has suffered sudden cardiac arrest .  The technique involves no mouth to mouth contact and is best used in emergencies outside of hospitals where a bystander has seen another person suddenly collapse. The important part to remember here is you should see the person collapse.

If you see a person collapse and they are not breathing put one hand over the other and begin pumping on the chest just below the nipples. Pump at a rate of about 100 beats per minute.  You do not have to be certified, to perform Hand Only CPR.

Traditional CPR Change

The other big change is to traditional CPR steps. There will be a switch in the process of how to do CPR. For many years the steps have been ABC. Open Airway, give 2 Breaths and then 30 Compression of the chest.

Now the order will be giving compressions first then the breathing. Getting the blood circulating is much more important then taking the time to open the airway and give the breaths.

If you are certified in CPR the change will not be hard to make.

If you are not certified, this is a great opportunity to take a class, and have the knowledge that some day you might be able to SAVE-A-LIFE.

If a stranger passed out on the sidewalk in front of you, how likely would you be to administer mouth-to-mouth?

In our age of no-touch faucets in public bathrooms and special disinfectant wipes for grocery store carts, you wouldn’t be alone if you say you might hesitate.

Happily, two new studies conclude that when it comes to CPR, pressing rhythmically on the chest with your hands is enough to save a life.

No mouth-to-mouth required.

The American Heart Association, which has been promoting hands-only CPR for two years, hopes that bystanders will feel less apprehensive and more likely to act if faced with an emergency.

Studies indicate that fear of doing something wrong, more so than catching something, makes many would-be-heroes freeze. And people may have has good reason to fear doing something wrong when practicing traditional mouth-to-mouth CPR.

The traditional method is a bit complicated, and one study showed that those who did attempt it often didn’t do it very well. For starters, the victim’s head has to be tilted back, the airway cleared, the nose pinched and the mouth completely covered with the rescuer’s.

There are many opportunities for air to escape, and some experts believe that some bystanders perform mouth-to-mouth so poorly that the interruption reduces blood flow.

Yet the aim of CPR is to do some of the mechanical work of the heart by forcing at least some blood and oxygen to the brain and other vital organs, which is why chest compressions work.

The only cases in which mouth-to-mouth seems to make a difference is when the victim is a child, or in cases of adults who have stopped breathing because of choking, drowning or other respiratory problems.

The Federal Emergency Management Agency has released a new report titled Personal Preparedness in America: Findings from the 2009 Citizen Corps National Survey that offers data on the public’s thoughts, perceptions, and behaviors related to preparedness and community safety for multiple types of hazards. FEMA says the report’s findings are particularly relevant as the nation prepares for a possible pandemic flu outbreak, hurricane season, and other hazards.

Results from the national survey have important implications for the development of more effective communication and outreach strategies to achieve greater levels of preparedness and participation, the agency says. For example, the results indicate that 30 percent of Americans have not prepared because they think that emergency responders will help them and that more than 60 percent expect to rely on emergency responders in the first 72 hours following a disaster. While government will execute its functions, communications to the public should convey a more realistic understanding of emergency response capacity and emphasize the importance of self-reliance. FEMA concludes that messaging should thus speak to a shared responsibility and stress that everyone has a role to play in preparedness and response.

The survey also found that many people who report being prepared have not completed important preparedness activities or do not have a sound understanding of community plans. Of those who perceived themselves to be prepared, 36 percent did not have a household plan, 78 percent had not conducted a home evacuation drill, and 58 percent did not know their community’s evacuation routes.

Fourteen percent of respondents reported having a physical or other disability that would affect their capacity to respond to an emergency situation. Alarmingly, however, few individuals with disabilities had taken specific actions to help them respond safely in the event of an emergency, the study found. Only 27 percent had taken a CPR or first aid training and less than half (47 percent) had a household plan. Another 14 percent of survey participants indicated they lived with and/or cared for someone with a physical or other disability. Of these individuals, less than 40 percent reported taking a CPR or first aid training (36 percent and 39 percent respectively) and 53 had supplies set aside in their home.

The report notes that practicing response protocols is critical for effective execution; this is true for emergency responders and true for the public. Fewer than half the surveyed individuals (41 percent) had practiced a workplace evacuation drill, only 14 percent had participated in a home evacuation drill, and of those in school and/or with children in school, only 23 percent had participated in a school evacuation drill. And the numbers are much lower for shelter in place drills (27 percent, 10 percent, and 13 percent respectively). Drills and exercises for multiple hazards and multiple locations need to be conducted through social networks, the study found. In addition, community members need to be included more effectively in government-sponsored community exercises.

The survey results indicate that individuals’ perceived utility of preparing and their confidence in their ability to respond varies significantly by disaster type. Only 7 percent of individuals felt that nothing they did would help them handle a natural disaster, whereas 35 percent felt nothing they did would help them in an act of terrorism, such as a biological, chemical, radiological, or explosive attack. All-hazards terminology may mask important nuances relative to conveying personal preparedness guidance for specific hazards. The report thus says it is important to emphasize the survivability of manmade disasters and the relevant protective measures for these hazards.

The report notes that national leaders must be strong advocates for personal preparedness, but adds it is clear that messages specific to individual preparedness must include critical local information, such as information on local hazards, local alerts and warnings, and local community response protocols. Local social networks must also be used to support outreach and education on personal preparedness, such as neighborhoods, the workplace, schools, and faith communities. And the concepts of mutual support at the local, neighborhood level should be emphasized.

To read the survey report, go to www.citizencorps.gov/ready/2009findings.shtm.

The American Heart Assoication is adapting a new standard for CPR.  On March 31, an important advisory statement on “hands-only”  (compression-only) CPR was published in Circulation. This statement clarifies the 2005 AHA Guidelines for CPR and ECC, which included the recommendation that laypersons – or bystanders – should perform hands-only CPR if they are unable or unwilling to provide rescue breaths.  The Compliance Resource Center wrote about an article about a new study done in Lancet in April of 2007.  The Lancet study showed dramatic results when life-savers only had to worry about chest compressions without doing mouth-to-mouth breathing. 

”The report confirms that what we have learned in animal experiments applies to humans as well,” says Gordon A. Ewy, MD, director of the Sarver Heart Center at The University of Arizona in Tucson where chest-compression-only resuscitation was developed. “Bystander-initiated continuous chest compressions without mouth-to-mouth breathing are the preferable approach for witnessed unexpected collapse, which is usually due to cardiac arrest.”

Hopefully more people will consider doing CPR (compression only) on a person when needed.  Statistics show that when CPR is started and continued until help arrives, it can save lives.

A unified effort by the public, educators and policymakers is needed to reduce deaths from sudden cardiac arrest by increasing the use and effectiveness of cardiopulmonary resuscitation (CPR), according to a statement from the American Heart Association. The statement, “Reducing barriers for implementation of bystander-initiated cardiopulmonary resuscitation,” appears online in Circulation: Journal of the American Heart Association.

“Bystander cardiopulmonary resuscitation rates are woefully inadequate, resulting in an enormous missed opportunity to save lives from cardiac arrest,” said Benjamin S. Abella, M.D., M.Phil., clinical research director for the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia, and lead author of the statement.

Studies indicate that in many communities only 15 percent to 30 percent of out-of-hospital cardiac arrest victims receive bystander CPR before emergency medical services (EMS) personnel arrive at the scene. Considering that cardiac arrest survival falls an estimated seven percent to 10 percent for every minute without CPR, the low rate of bystander CPR has a big impact on outcomes, he explained.

Approximately 166,200 out-of-hospital sudden cardiac arrest deaths occur annually in the United States. Sudden cardiac arrest often results from an irregular heartbeat called ventricular fibrillation (VF) which causes the heart to quiver so that it cannot generate blood flow. Treatment of VF requires CPR to keep blood moving through the body until the patient’s heart can be shocked to terminate the VF and allow the heart’s pacemaker cells to establish a normal rhythm, AHA officials said.

In the last decade, automated external defibrillators (AEDs), portable defibrillation machines, have become increasingly common in public buildings such as casinos, airports and schools. However, Abella said defibrillation is only one of the four links in the Chain of Survival, a sequence of four actions that must occur quickly to help assure the best chances of survival.

The Chain of Survival requires:
early recognition of the emergency and phoning 911 for EMS.
early bystander CPR.
early delivery of a shock via a defibrillator if indicated.
early advanced life support and post-resuscitation care delivered by healthcare providers.

“Quick initiation of CPR, as well as providing high quality CPR, is crucial to survival,” Abella said. “What’s needed is a two-pronged approach: first, substantially increase the number of bystanders trained in CPR who then provide CPR during an actual emergency and second, improve the quality of training and actual CPR performance through measures of its effectiveness.”

The statement identifies specific potential barriers to improving U.S. cardiac arrest survival rates including: fear of infectious disease, fear of litigation and fear of poor performance, all of which Abella said could be overcome with adequate education, training and public awareness.