The New CPR

The New CPR Chest-pushing replaces mouth-to-mouth?



MONDAY, March 31 (HealthDay News) -- If you see someone collapse ina public place or at home and you think it might be a heart attack,start pushing on his or her chest as hard as you can and as often asyou can.
0 r  \+ [; d+ d/ U4 D' oThose are the latest instructions from the AmericanHeart Association, which asserts that hands-only cardiopulmonaryresuscitation (CPR) can be done in an emergency situation, even bypeople who have no training in the technique.
The statement, published in the April 29 issue of Circulation,does not rule out mouth-to-mouth breathing as part of CPR. "But we havelearned enough to say that passers-by can save lives with chestcompression alone," said Dr. Michael Sayre, an associate professor ofemergency medicine at Ohio State University and chairman of the AHAcommittee that wrote the statement.
"We believe thatapproximately 250,000 Americans suffer cardiac arrest each year," Sayresaid. "Perhaps 15,000 of them will live. We believe that getting morepeople to do CPR could probably save thousands of lives a year."
; d8 S; k% O5 iThedetails of traditional CPR -- how often and how hard to push -- can beignored, Sayre said. "We've done a little bit of research to suggestthat most people are not likely to push hard enough and it's difficultto push too hard or too fast," he said.
/ P& _0 o( n$ bDr. Benjamin S. Abella,clinical research director at the University of Pennsylvania Center forResuscitation Science, added, "in a case of cardiac stress, it'sprobably unrealistic for a member of the public to know what 100 pushesa minute and 2 inches of depth are."
So the new guidelines workout to a simple two-step measure: First dial 911 to call for emergencymedical help, then begin hands-only CPR.
; K# L. h  @! v& j. I7 I4 s"It's fairly clear thatCPR, when done by any standard, can double or potentially triplesurvival," Abella said. "That is great enough to warrant any risk."
3 h7 b4 \* T9 m7 |* i8 sThehands-only advice also eliminates a potential hindrance to providinghelp -- fear of what might happen with mouth-to-mouth contact, Abellasaid. "This allows bystanders to do a simpler form of CPR that avoidsmouth-to-mouth contact with a stranger," he said.
4 L* A! i  p( rThe newrecommendation for hands-only CPR is an update to 2005 American HeartAssociation guidelines, which said bystanders should usecompression-only CPR if they were unwilling or unable to providebreaths. Three studies published in 2007 showed no negative impact onsurvival when mouth-to-mouth ventilation was eliminated, theassociation statement said.
' s' F9 y8 a% y$ o% SIt's still best to have CPR done inthe conventional way by medical personnel trained in the technique, theheart association said. The new recommendation applies only tobystanders who come to the aid of adult cardiac arrest victims outsidea hospital setting.
Hands-only CPR should not be used on infantsor children, or adults whose cardiac arrest is from respiratory causessuch as drug overdose or near-drowning.
About 75 percent of allsudden cardiac arrests happen at home, the heart association estimates,and the new guideline applies in such cases: 911 first, hands-only CPRsecond.