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CPR Not as Effective as Chest Compressions Alone
patiwat writes "A Japanese study detailed in the New York Times has found that people suffering from cardiac arrest were more likely to recover without brain damage if rescuers focused on chest compressions rather than on rescue breaths. Some experts advised dropping the mouth-to-mouth part of CPR altogether. Interrupting chest compression to perform mouth-to-mouth ventilation might do more harm than good if blood flow to the heart was not properly re-established, a researcher from Tokyo's Surugadai Nihon University Hospital said. According to the article, 'More than 300,000 Americans die from cardiac arrest each year. Roughly 9 out of 10 cardiac arrest victims die before they get to a hospital — partly because they do not get CPR.'"
This year the Red Cross changed their standard from 2 rescue breaths every 15 compressions to 2 rescue breaths every 30 compressions (or that is what my yearly training reflected). They also removed abdominal thrusts for unconscious choking victims and basically made the care the same as for a heart attack (minus the AED). I had thought they were dumbing the program down (in the case of choking)so the average person who takes first aid/CPR wouldn't have too many things to remember. Now I see that rescue breaths are generally without merit. I wonder if my training next year will reflect this particular study.
So if the person is still breathing but their heart has stopped, rescue breaths provide no benefit. DUH!
It's not that much of a 'duh'. The idea originally behind CPR is that you manually perform the action of the heart through the chest compressions, and that the chest compressions don't do much good without some fresh O2 in there. As such, one could ask what good CPR is without the breathing part?
The research basically just shows that circulating the remaining O2 in the blood and stimulating the heart muscle is much more valuable than stopping occasionally to ensure the air is fresh, but that's not a determination you could make with no education, experience, or actually performing the research.
If you're going to call 'duh', you're asserting thay you know more about medicine than the medical professionals who created it and have practiced it all these years. I don't think that's the case, and as is usually the case, the facts are more complicated than it seems to laypeople.
A key caveat here is that the average joe will have great difficulty recognizing if a victim is suffering from cardiac arrest or respiratory failure: in this case, a combo is the safe approach that covers the most bases.
In my own humble experience, a person with heart failure will gasp and breathe as soon as blood flow is established.
With a drowning victim it is the other way around - their hearts are OK, but their lungs are full of water, so getting them to breathe/cough/drain is more important - their hearts will beat OK.
So, some intelligence is required. You have to analyze the situation, not just start full resussitation if you don't know what/why you are doing it.
Excuse me, but please get off my Pennisetum Clandestinum, eh!
Personally, if someone next to me went into cardiac arrest right now, I would do as my training said and do the 15 to 1 ratio. If I could verify that the American Red Cross teaches otherwise in the Adult CPR course, I would follow those new procedures. However, if the adult CPR course said 15 to one and the CPR for the professional rescuer said 30 to one I would do 15 to mone because I never took a CPR for the professional rescuer course.
This is the reason your CPR card has an expiry date. If you don't stay current and perform an inadequate CPR technique, technically you are liable (although it's unlikely you'd be sued). I renewed my ACLS certificate a few months ago and can confirm the new 30:2 ratio is endorsed by the American Heart Association. Other changes were made to airway obstructions, too.
If you want to do CPR I suggest you take a refresher course. Cracking ribs is lots of fun (I've personally reanimated hundreds of people and it's nice when it works), but you have to do it properly if you want to give the patient his best chance at living again.
Seven puppies were harmed during the making of this post.