Thursday, September 1, 2011

The New Cardiopulmonary Resuscitation Guidelines

Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning. A situation when someone's breathing or heartbeat has stopped. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. Ideally, CPR involves two elements: chest compressions combined with mouth-to-mouth rescue breathing. However, what you as a bystander, should do in an emergency situation really depends on your knowledge and comfort level. The bottom line is that it's far better to do something than to do nothing at all.
This is what I, as a physician of thirty years, recommend to those who ask me what they should do.
If you're not trained in CPR, then provide hands-only CPR. That means uninterrupted chest compressions of about 100 a minute until paramedics arrive. You don't need to perform rescue breathing. If you've previously received CPR training, but you're not confident in your abilities, then just do chest compressions at a rate of about 100 a minute. This is the "magic number", 100! It's the only real number you need to remember. If you're trained, and confident in your ability, then you can opt for one of two approaches: Alternate between 30 chest compressions and two rescue breaths, or just do chest compressions.
This advice applies only to adults needing CPR, not to children.
Cardio Pulmonary Resuscitation changed this year, as statistically, "mouth to mouth" shows no significant improvement in CPR effectiveness. This applies to adults and not to children. Mayo Clinic findings have convinced experts to remove the mouth to mouth component out of the protocol traditionally endorsed by the American Heart Association and The American Red Cross. Even without mouth to mouth, the compressions alone, are delivering about 70% oxygenated blood to the brain, giving the victim a huge chance for survival. The alternative, "doing nothing at all", is fatal.
I am often asked, why doesn't this apply to children? The reason is that most CPR events occur with older adults who have had a cardiac event which renders them unconscious and unresponsive. Children, on the other hand, are generally healthy and robust from a cardiac stand point. They do not generally have heart attacks, and do not usually suffer from cardiac arrest unless already air starved from a life threatening pulmonary condition such as an asthma attack, depleting them of oxygen. Therefore, replacing oxygen (mouth-to-mouth breathing) is critical for their survival.
Do the smart thing. Get certified in CPR. Always be prepared to make a difference, and be able to save someone's life.

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