The American Heart Association announced Monday that hands-only CPR is just as effective as standard CPR for sudden cardiac arrests in adults.
Experts hope the announcement will make bystanders more likely to assist someone who suddenly collapses, since hands-only CPR ““ quick, deep presses on the victim’s chest until help arrives ““ is simple and easier to remember. It also removes a major barrier for some who may be skittish about mouth-to-mouth breathing.
“You only have to do two things. Call 911 and push hard and fast on the middle of the person’s chest,” Dr. Michael Sayre, an emergency medicine professor at Ohio State University who headed the committee that made the recommendation, told the Associated Press.
The recommendation calls for continuous chest presses at a rate of 100 per minute, done until either paramedics can take over or an automated external defibrillator is available.
It is estimated that 310,000 Americans die each year of cardiac arrest outside hospitals or in emergency rooms. Although data varies by location, only about six percent of people who suffer cardiac arrest outside a hospital survive. But those who can quickly get CPR before receiving medical treatment up to triple their chance of survival.
Unfortunately, less than a third of victims receive the essential CPR that may save their lives.
Hands-only CPR should only be performed on adults who unexpectedly collapse, stop breathing and are unresponsive, symptoms that would likely indicate a person is experiencing cardiac arrest. In such a case, the victim has an adequate amount of air in the lungs and blood, and CPR compressions would keep blood flowing to the brain, heart and other organs.
In the case of a child who collapses, the underlying problem is more likely to be a respiratory issue, and mouth-to-mouth breathing should be used. This would also apply to adults who experience near-drowning, drug overdose, carbon monoxide poisoning or other situations where the victim suffers a lack of oxygen. For these people, mouth-to-mouth is needed to get air into the lungs and bloodstream.
But Sayre added that in either case, doing “something is better than nothing.”
The CPR guidelines had been trending toward compression-only for some time. The previous update, in 2005, emphasized chest pushes by alternating 30 presses with two quick breaths in between. For those “unable or unwilling” to do the breaths, chest presses alone were advised. The new recommendations, however, now give equal weighting to hands-only CPR, adding that those who have been trained can still choose to perform traditional CPR.
Sayre said the heart association decided to update their recommendations now, rather than in 2010 when the next update was due, after three studies last year found that hands-only was as good as traditional CPR. Hands-only will be added to the association’s CPR training.
Dr. Gordon Ewy, director of the University of Arizona Sarver Heart Center in Tucson, where the compression-only technique was pioneered, has been advocating hands-only CPR for 15 years. He said the new recommendations had him “dancing in the streets”.
Ewy said it was pointless to give cardiac arrest victims early breaths because the 16 seconds required to stop compressions and give the two breaths is too long. He explained that victims often gasp periodically anyway, drawing in small amounts of air on their own.
Ewy cited anonymous surveys that found some people are reluctant to perform mouth-to-mouth, in part because of fear of infections.
“When people are honest, they’re not going to do it,” he said. “It’s not only the yuck factor.”
In recent years, emergency service dispatchers have been advising and coaching callers to perform the hands-only CPR, instead of the traditional CPR technique.
“They love it. It’s less complicated and the outcomes are better,” Dallas emergency medical services chief Dr. Paul Pepe told the Associated Press. Pepe chairs emergency medicine at the University of Texas Southwestern Medical Center.
Jared Hjelmstad, 40, a chiropractor in Temecula, Calif., has been spreading the word about hands-only CPR after he helped save the life of a fellow health club member in Southern California. Hjelmstad had read about it in a medical journal, and performed it on Garth Goodall, a 49-year-old construction contractor, after he collapsed while working out at the gym in February. Hjelmstad’s 15-year-old son Josh called 911 in the meantime.
Hjelmstad said he performed the hands-only CPR on Goodall for more than 12 minutes until paramedics arrived, and was overjoyed the next day to learn that Goodall had indeed survived.
On Sunday, he visited Goodall in the hospital where he is recovering from triple bypass surgery.
“After this whole thing happened, I was on cloud nine,” Hjelmstad told the AP. “I was just fortunate enough to be there.”
“It’s a second lease on life,” said Goodall, adding that he had been fit and healthy prior to the collapse, and there had been no hint that he had clogged heart arteries.
“I was lucky,” he said. If the situation were reversed, “I wouldn’t have known what to do.”
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