September 18, 2006
AHA Pushes to Double Those Who Know CPR
WASHINGTON - Teach yourself CPR? The American Heart Association says you can, with the help of an inflatable mannequin named Mini Anne and some simplified instructions. It's part of a new push to nearly double the number of people who learn cardiopulmonary resuscitation.
The urgency: Those heart-zapping defibrillators that are everywhere from shopping malls to people's homes often aren't enough to save lives "” unless someone also performs CPR. The machines keep EKG-like recordings of heart rhythms that tell the tale of the almost-saved.
It's a message that's been somewhat overshadowed by the gee-whiz technology of "automated external defibrillators," or AEDs.
"People are doing the right thing in establishing lay-rescuer AED programs. Now we need to come back and make sure there's sufficient emphasis on the CPR and not just on the technology," says Mary Fran Hazinski, a clinical nurse specialist at Vanderbilt University Medical Center, who helped the heart association develop its newest CPR guidelines.
More than 300,000 Americans each year die of cardiac arrest. The heart's electrical system abruptly goes haywire so that the heart quivers instead of beats, and the victim collapses. Without help, death occurs within 10 minutes, before an ambulance can arrive.
Portable defibrillators can increase survival, delivering a jolt of electricity that stuns the heart to end the abnormal rhythm and giving it a chance to resume a normal beat. The easy-to-use devices literally talk rescuers through the steps, and are widely touted as foolproof because they won't shock a heart that's in normal rhythm.
CPR buys the victim crucial time by keeping blood circulating to the brain and other organs until a defibrillator arrives. Less obvious is that CPR often is needed immediately after the heart is zapped, too.
Hazinski describes recordings from defibrillators used in bystander rescue attempts that show people died even though the shock did its job. Why? Apparently the hearts were too starved of blood to get back on track without circulation provided by the chest compressions that are CPR's core.
"Nobody does CPR, and slowly that rhythm just dies out. That's tragic," she says. "You can just see missed opportunities."
More than 11.4 million people a year are taught CPR by either the American Heart Association or the American Red Cross, the two largest trainers; almost half are paramedics or other health workers, says a new analysis by the AHA's scientific director. The AHA's goal: To train at least 20 million people a year by 2010, with an emphasis on laymen "” the office workers or family members who are most likely to witness a cardiac arrest.
As part of that training push, the heart association last December issued new guidelines to make CPR simpler. Push the chest hard and fast, they stress.
Now enter the $30 Mini Anne kit, called CPR Anytime. The idea: More people might learn CPR if they didn't have to attend a four-hour class "” and having your own at-home mannequin allows more practice time than sharing classroom mannequins does.
Simply blow up Anne, and watch a training video that shows how to compress the chest "” 2 inches deep, 30 times in a row "” followed by two breaths into the "victim's" lungs. Anne's chest clicks when pushed right, a response to recent research that found CPR too often is too wimpy, even when performed by doctors, nurses and paramedics.
What's missing with teach-yourself CPR? The tips that a veteran instructor who's performed CPR during real emergencies might offer.
It's the messiness and mayhem that will distract you, Red Cross instructor Sonya Glover warned a recent class. Mannequins don't sweat or bleed or urinate like a typical patient, or have screaming spouses who may hinder lifesaving efforts.
While practicing CPR, "in the back of your mind you should be thinking, 'What if this was a real situation?'" she stressed. "Keep yourself focused."
Still, a series of studies, including one published last fall in the journal Resuscitation, suggests average people can learn CPR as well with 30 minutes of video self-instruction as they do in standard classes. And the heart association estimates that two or three people may get trained by each CPR Anytime kit, as purchasers pass Mini Anne on to family members.
The teach-yourself program doesn't allow users to become formally certified in CPR, like people who complete a formal AHA or Red Cross course are. But the heart association is developing a more in-depth version, with additional defibrillator training, that eventually will allow certification for people who pass a test at a CPR training center.