Whats the difference between old CPR and New CPR? CPR (Cardio pulmonary Resuscitation) Written by Mitchell Paulse (retired BLS medic and first aid training director for MPFA) The history of CPR goes back as far as 1740, when the Paris Academy of Sciences officially recommended mouth-to-mouth for drowning victims. More than 100 years later, Dr. Friedrich Maass performed the first documented chest compressions on a human. Since then, CPR has evolved from a technique performed by doctors and physicians into a life saving skill that almost anyone can learn. A skill that has saved thousands of lives worldwide. For many years, the CPR sequence was always HAZARDS, HELLO, HELP, AIRWAY, BREATHING & CIRCULATION. However in 2010 the American Heart Association started to recommend HAZARDS, HELLO, HELP, SIGNS OF LIFE, CIRCULATION, AIRWAY & BREATHING. These changes were based on five years of world wide research into cases where CPR was used. The AHA now also recommends 30 compressions & 2 breaths for CPR and not 15 compressions & 2 breaths as previously shown. The other major change in the CPR sequence is that a “pulse check” & “checking for breathing” is no longer part of CPR. So why the major changes? Let first have a closer look at why “pulse check” & “checking for breathing” has been removed. Through research, the AHA found that quite often members of the public & medical professionals got the pulse check” & “checking for breathing” wrong. Wrong in the sense that they thought they felt a pulse or saw the patient breathing, however there was nothing. This delayed CPR terribly and was often fatal for the patient concerned. Starting the sequence with breaths was also causing delays. The reason is that most people do not carry around a CPR mouth shield or barrier on them. So they would wait for the first aid kit to arrive, retrieve a mouth shield and only than start CPR. These actions delayed CPR by as much as 10 minutes. Now considering the victim has around 4 to 6 minutes before brain damage occurs, that is quite a significant delay! During AHA’s worldwide research, they found that people who did more chest compressions had a larger success rate. However more than 30 chest compression becomes counter productive as the patient is running out of oxygen in the blood stream. The AHA also discovered that people who were doing the chest compressions faster (at least 100 compressions a minute) has higher success. Here are some questions that are often asked in my CPR classes about the changes and about CPR in general. Can I get into trouble for doing CPR on someone that I don’t know? No, the Good Samaritan laws protect you. This law states that you were only doing what any reasonable human being would do in the same situation. How can my breaths help some one, don’t we breath out carbon dioxide? Yes, we do breath out carbon dioxide. We also breathe out oxygen and small amounts of other gases. The human body does not use all the oxygen that we breathe in, unless we hold our breath for a long time. Am I going to break his/ her ribs when I do CPR? As long as you are pressing directly on the sternum (centre of the chest), the chances of breaking ribs is very remote. However some ribs may dislocate from the sternum during CPR. This will not damage the heart and lungs as the ends of our ribs are covered in cartilage. If I don’t check for a pulse or check for breathing, how will I know that he/she needs CPR? The AHA recommends “scanning” the face and chest of the victim, looking for any signs of life. Signs such as the chest rising and falling or any movement from the patient. If you are not sure, start CPR. But if I start CPR and he/she does not need it, won’t I stop his/her heart? No, that is a myth. The heart is a muscle and will adapt to you chest compressions. Also if your patient does not need CPR he/she will respond! How hard must I push on the victim’s chest during CPR? You need to make the chest move around 10cm or a third of the chest depth. Anything less will not be effective. Rather too hard than too soft. By starting with chest compressions first, am I not starving the patient of oxygen? When someone collapses from cardiac arrest, there is still 6 to 8 minutes worth of oxygen in the body’s blood stream. However if we don’t get that oxygenated blood moving, the brain is going to die. Can I stick a pen in the patients throat to help him breath? Definitely not! You will do more damage than good. Besides, a pen or a straw is too narrow to breathe through. But this is different to CPR that the do on TV or in the movies? TV programs and movies focus more on dramatic effect than accuracy. If you want to learn CPR, please contact an accredited CPR training centre. So now let us have a look at the new sequence. HAZARDS – STOP AND MAKE SURE THAT THE SCENE IS SAFE FOR YOU, BYSTANDERS & THE PATIENT HELLO – TAP THE PATIENT ON THE SHOUDERS AND SHOUT “ARE YOU OK?” HELP – CALL FOR AN AMBULANCE STRAIGHT AWAY (112/10177/082911/084124) SIGNS OF LIFE – LOOK AT PATIENTS FACE AND CHEST FOR BREATHING OR ANY MOVEMENT CIRCULATION – START WITH 30 CHEST COMPRESS IONS, PUSHING HARD AND FAST AIRWAY – TILT THE PATIENTS HEAD BACK TO OPEN THE AIRWAY BREATHING – GIVE THE PATIENT 2 BREATHS CONTINUE UNTIL THE PARAMEDICS ARRIVE, PATIENT RESPONDS OR YOU ARE TOO EXHAUSTED TO CONTINUE. Anyone can learn CPR – and everyone should! Sadly 70% people feel helpless during a cardiac emergency because either they do not know CPR or it has been a long time since they did CPR training. This is an alarming statistic as 4 out of 5 cardiac arrests happen at home. The life you save with CPR will most likely be a loved one. Sources: 2010 AHA Guidelines for CPR & ECC (Emergency Cardiovascular Care)
Posted on: Tue, 13 Aug 2013 14:47:54 +0000
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