AP: Experts Now Recommend Hands-Only CPR

Sorry, kids. There'll be no more practicing mouth-to-mouth with your little friend in your bedroom.

Oops. Practice on!

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So... If they stop breathing, you do mouth to mouth. If their heart stops, you do chest compressions.

How is this any different from how it's supposed to be done?

Is this article suggesting that CPR (as in m2m + cc) was being taught as some kind of one-size-fits-all thing in lieu of, oh, I dunno, actual judgment?

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- Moose's one-line review.

"your going to regret that one. You are now a colonoscope...
- Chrissy, corrupting PraedSt's wish.

I was taught, oh... decades ago, that if the heart is stopped (and breathing will be too), you did chest compressions and mouth to mouth, interleaved. Sounds like the new recommendation is just the chest compressions as that itself moves the air.

(And it remains that if the heart is beating you do not do chest compressions.)

Edit: In a different article it's made clearer that the advice is not for CPR-trained people. WebMD: Hands-Only CPR Gets Thumbs Up

I guess maybe CPR is still your father's CPR after all.

This new, other thing seems to be for those who don't know how to, or don't want to, do CPR.

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01101001 had it basically correct.

In adults, the main problem is heart failure. And when the heart stops beating, the respirations stop too. The idea of "only compressions" is that keeping circulation going is the most important thing, if you can do that, there is still a little oxygen in the blood, and one of the biggest fears people have with doing CPR is mouth-to-mouth and getting a disease. Plus, I remember reading an article years ago that chest compressions on their own will move a little bit of air in and out of the lungs.

Sure, old fashioned CPR (breathes and compressions) is better, but compressions alone are better than nothing (which is what happens around 70% of the time).

For kids, it is a completely different story. They usually first suffer from respiratory failure, which, if untreated, leads to the cardiac arrest. If they are given mouth-to-mouth quickly enough, you can prevent them from going into cardiac arrest. I also suspect that the average person has less fear about giving mouth-to-mouth to a child or infant.

My personal problem is that I've been taking CPR for almost 30 years, and I thought it for about 10. Just this last year, there was another change in the technique, and it takes this old dog a couple of years to learn a new trick. But as I thought my students, non-perfect CPR is much better than none at all. The patient is already dead, they can't get worse.

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At night the stars put on a show for free (Carole King)

One Earth, One Sky - IYA 2009

What's the new change, Swift? I'm not current.

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In Fallout 3, 'happiness' is a warm junkyard dog and a loaded gun. It's mostly the loaded gun.
- Moose's one-line review.

"your going to regret that one. You are now a colonoscope...
- Chrissy, corrupting PraedSt's wish.

The European training (which I think matches the US) has been to start with thirty compressions, and then give two breaths, and repeat until help arrives. (That's a de-emphasis of breathing already, since the previous protocol was to start with two breaths, and then give fifteen compressions, then repeat.)

But there's been a lot of evidence that inexperienced people:
1) Will delay or avoid mouth to mouth contact
2) Are pretty hopeless at delivering effective breaths anyway
3) Take a long time out from the compression cycle while fiddling with the airway

Meanwhile, there's scientific evidence that:
1) Gaps in the compression cycle are very bad for your chance of survival
2) Compressions move air in and out anyway
3) Compression-only CPR produces similar survival to the standard method

So this is a new guideline for bystander CPR, in the hope that it will produce better outcomes in the hands of amateurs outside hospital. If you have your cardiac arrest in hospital, someone expert in the technique is still going to secure your airway and ventilate your lungs with oxygen.

Grant Hutchison

What grant said. The compressions are also given at a faster rate.

At least I think those are the changes. I've had the new training once and I have to admit that if I suddenly had to do CPR, I would probably, out of habit, do 15:2.

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At night the stars put on a show for free (Carole King)

One Earth, One Sky - IYA 2009

The thinking behind this is outlined in some detail in the AHA Science Advisory (7-page pdf). In particular, it emphasizes that the casualty is going to need some airway/breathing intervention at some point, since the oxygen saturation steadily declines during compression-only CPR.

The rate advice seems to be just "hard and fast", rather than trying to get inexperienced people to reproduce the 100/min compression rate recommended for trained personnel.

Grant Hutchison

I likely would as well. It's hard for me to untrain something I've trained myself to do, right or wrong.

__________________
In Fallout 3, 'happiness' is a warm junkyard dog and a loaded gun. It's mostly the loaded gun.
- Moose's one-line review.

"your going to regret that one. You are now a colonoscope...
- Chrissy, corrupting PraedSt's wish.

I remember the early years when I was taught CPR, the rules was if the heart was stopped, to start with three strikes to the chest, then check again.
I believe the thought at the time was that if the heart hadn't actually stopped but was in fibrillation this might be enough to break the heart out of it, either to get beating again or stop completely so it wasn't actively counteracting the subsequent pumping.
This changed so this shouldn't be done, possibly to prevent perforated lungs after adrenalin-boosted blows by a near panicking helper

I haven't kept my training current, so I'm still at the 15:2 which I expect is still considered better that hand-wringing bystanderism

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Absolutely correct ( I like "bystanderism" ).

By the way, the thump on the chest can get a heart out of fibrillation, but only if it is done within the first few moments (the heart has to still be very well oxygenated for one) and if done properly. So, in theory, it can be helpful for a witnessed arrest and a well trained rescuer.

But that so rarely happens, and it is much more likely that all that will happen is the rescuer will just break a bunch of ribs, that it was dropped long ago.

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At night the stars put on a show for free (Carole King)

One Earth, One Sky - IYA 2009

My office is due for its annual Red Cross CPR retraining sometime next month. It should be interesting to see if they change the program that quickly. If it has boiled down to "press hard and fast", the training is going to be short this year

In one of the previous trainings, they told us that if the person is not breathing, we should start CPR without checking for a pulse. The reasoning is that most (untrained and minimally trained) people have trouble determining if a person has a pulse and waste lots of time trying to find one. They also sometimes find their own pulse, which delays the application of CPR.

As for your "father's CPR", I recall learning rescue breathing techniques called "back-pressure arm lift" and "chest pressure arm lift" back in the 1970s. I can also recite the definition of First Aid from memory. That may come in handy if I ever find myself on a trivia game show.

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"That's Not Blight. It's New Jersey" - The Wall Street Journal

I'm guessing these are most likely the reasons