American Heart Association Promotes Hands-Only CPR
Well, this one came out of left field today. This afternoon the American Heart Association issued a press release promoting hands-only CPR or what some have called compression-only CPR. What is somewhat startling about this is not the recommendation of compression-only CPR in itself (which has been a subject of discussion for many years), but the timing of this release. Whereas, in the past, the AHA has normally issued revisions in the CPR guidelines in five year cycles and after many levels of peer review, including the International Liaison Committee on Resuscitation (ILCOR), they have issued this “clarification” prior to the scheduled October 2010 Consensus Conference. I guess that is why they are calling this a “clarification” of their 2005 ECC guidelines rather than a guideline change.
You might be wondering, ‘Will this change how I do CPR if the needs should arise in our office?’ Well, not really. Keep in mind that hands-only CPR does NOT replace the need for traditional CPR in many cases. It is just being promoted as a viable option, even a preferred option, in certain situations.
When is hands-only CPR now being recommended? Under the following circumstances:
- Event occurs out-of-hospital
- Patient is an adult
- When a sudden collapse is WITNESSED (most likely cardiac arrest)
If all of the above conditions are met then it would be advisable to do compression-only CPR without the ventilations. You would do continuous compressions, on the center of the chest, at a rate of 100 per minute (to the beat of the Bee Gees song, “Stayin’ Alive”). You would continue with compressions until the patient responds, an AED arrives, or until EMS arrives.
Under what circumstances would you perform traditional CPR rather than Hands-only CPR?
- Patient is a child or infant (event is more likely respiratory in nature)
- Collapse is NOT witnessed
- Event occurs in-hospital or in your dental practice
- Cardiac arrest due to noncardiac origins (e.g. drowning, drug overdose, etc)
Of course as always, if a rescuer is unsure of his ability to do traditional CPR or is unwilling to provide ventilations due to circumstances (e.g. no breathing barrier available) then it is better to Hands-only CPR rather than nothing at all.
Why does the American Heart Association feel will be the benefits of this clarification?
Well, studies show that in most US cities the prevalence of bystander CPR remain relatively low at around 27%-33%. Why is there reluctance to perform CPR on the part of between 67%-73% of bystanders (many of whom have had training in CPR)? Studies reveal that the reason most cited are panic and fear of causing harm to the person. In a nutshell, many question their ability to perform CPR correctly. Another factor, although far less frequently mentioned, is the fear of disease transmission.
It is the hope of American Heart Association that the clarification of when Hands-only CPR is to be performed will increase the prevalence of effective bystander CPR. Of course, time will only tell if it has the desired effect.
If you want more information, check out the American Heart Association Hands-only CPR website.