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I have to admit—as a certified graduate of a cardio-pulmonary resuscitation (CPR) course—the first time I saw a link for online instruction in CPR I didn’t know whether to be amused or appalled. I still have no doubt that a live training course is the best way to learn CPR, and will address specific reasons for that below. That said, I also have to admit that I am impressed by the online resources that are now available just through typing “how to CPR” into the search box.
One of the things I have just learned is that as of October 2010, new guidelines have been issued for how to start CPR, and the usefulness of doing only chest compressions—“hands only CPR”—has been established and is actually recommended for lay rescuers who do not have classroom training:
- [2010 guidelines stress immediately calling 911] and starting chest compressions for any unresponsive adult victim with no breathing or no normal breathing (e.g., only gasps)….
- Initiate chest compressions before giving rescue breaths….
- [Chest compressions must allow] complete recoil of the chest after each compression…The recommended depth of compression for adult victims has increased…to a depth of at least 2 inches.
Quick Summary of the “New” CPR (with illustrations here):
- CALL—If a person is not responsive and not breathing or not breathing normally, call 911 and return to the victim. The dispatcher can usually coach you through CPR.
- PUMP—If the victim is still not breathing normally, coughing or moving, begin chest compressions. Lace fingers and push down in the center of the chest 30 times. Pump hard and fast, compressing the chest at least 2 inches at the rate of at least 100/minute, faster than once per second. Release all pressure from the chest to allow full expansion between each pump.
- BLOW—Tilt the head back and lift the chin. Pinch nose and cover the mouth with yours—for a small enough child, cover both mouth and nose with your mouth—and blow until you see the chest rise. Give 2 breaths, one second each.
About.com First Aid expands on this procedure with some contingencies, and offers videos as well.
Those already trained in CPR will note that the previous “Look, Listen, and Feel” instructions to assess breathing have been discarded in favor of a quicker observational assessment. The changes were based on effectiveness research, and made in the hope that simplifying the start of the process and promoting the hands-only option would increase participation by bystanders who witness a collapse, with the expectation that professional rescuers would have the expertise to modify the procedures as appropriate for particular cases.
Parents, Get Yourself Real Training!
Parents and those responsible for children’s safety should take note: Although survival rates among adults are about the same whether rescue breathing is administered or not, children do better with the classic combination of compression and rescue breathing. The consensus is still that proper placement of the head to clear the airway is best learned in hands-on classroom training if it is to be effective.
For parents, it is also good to have exposure to a trainer who has been in the trenches and can help address not only the mechanics of the technique but the anxieties and contingencies that can arise. For instance, what if you think you break a rib while administering CPR to your spouse or child? (Answer: keep going.) What if you think you might have punctured a lung? (Answer—you guessed it—keep going.)
You also may find, as I did, that certain things are not anticipated in a one-size-fits-all online template. No guide that I have seen, for example, shows the rescuer lying next to the victim to administer rescue breathing, but in my first attempt with the dummy that is exactly what I found myself doing as I alternated between breathing and chest compressions. The instructor was savvy enough to see that my technique worked best for me and gave it as an example to the class to be sure to do whatever worked for them.
Most online information sites link to training resources. If you are in a rural area, tracking down training might be yet another reason to get information on your local volunteer fire department, or to help with organizing one if none exists.
The Thing You Need to Know
Probably the most important thing I learned in CPR class is that the lay rescuer, despite what we may have seen on TV or in the movies, cannot expect that the recipient of CPR will return to consciousness. It simply does not work that way.
The real purpose of CPR is to keep blood and oxygen flowing to the brain until more elaborate attempts at revival can be administered by professionals. You are probably not going to be bringing anyone back from the brink without at least a defibrillator. Your intervention and perseverance can, however save a life or save a brain.
I am 86 years old, This sure does make more sense than I used when I was teaching resusitation methods in my older days. Keep it up. I think everyone should know this new and better method.
For 20 years I was an affilitate faculty member of the AHA teaching people to be instructor trainers in CPR. CPR can bring people back without a defibrillator, I have done it. A defibrillator is only good for someone in Vfib. If a person is flatline, CPR and drug therapy is there only hope. A defibrillator does not “jump start” a heart as commonly thought by most folks. It actually stops the heart and hopefully it will start up on it’s own. Too often I found, people were afraid to start CPR because they were afraid of doing it wrong and hurting the victim. The important thing to remember is the person is dead and you cannot hurt them, you can only help. You need to learn CPR in a classroom but learning about the proceedure online is better than nothing. The people who learn CPR in order to be able to help others are the true heros.
You also have to be careful to blow SLOWLY into a child so you don’t “blow their lungs out.” I too was a CPR instructor and wondered about this. I’ve even had a Dr. ask me about this as aposed(sp?) to the old way, as you are compressing the heart you also are compressing the lungs and allowing them to expand again. Very Interesting!
Everything mentioned is right. HOWEVER, Preppers should know where and why the changes were made, and why the NEW methods should be viewed with skepticism. As an ex-EMT and Red Cross instructor for 25 years, I’ve watched this develop. Every four years the ARC, the Heart Association, and some emergency MDs have re-examined CPR. Each time the result was to “simplify the technique” to encourage people to “do something”. OK.
Several years ago the University of AZ Medical School and Hospital wanted a way to keep people doing CPR even in the face of possible disease from mouth-to-mouth contact. We professionals used masks for protection. They found that there was enough tidal air flow using compressions only , even if it was not as good as the 2 breaths/20-30 compressions. Unfortunately the press got hold of the report and spread the “good news” that breaths are not necessary. The good doctors let the publicity go to their heads and blessed the change, forgetting that it was supposed to be an alternative method if safety was questionalble. Fine. Any CPR is better than no CPR.
With adults the preferred protocol for non-ambulance or hospital personnel was to call 911 ASAP because defibrillator was the best way to start the heart during many attacks. Children were always given breath-resuscitation first unless they had know heart problems. Also the availability of semi-automatic defib devices change the protocol particularly if there was someone else or a cell phone available to call 911.
So what is the problem? All of these protocols ASSUME that profession EMS (an ambulance with paramedics) will arrive within minutes (3-20 minutes in most urban areas). Now, just as I carry a gun (AZ has Constitutional Carry) because “when seconds count the police are minutes away.” So too, should Preppers be prepared to administer breath resuscitation, cardio compressions, and if possible defib. Just as with firearms, training and periodic practice are needed. To repeat myself: Any CPR is better than no CPR, but understand that “compressions only” was meant to be an alternative method. Also remember the assumption that EMS will arrive soon. CPR originally was meant to maintain oxygen to the brain; not to restart the heart. If you get a spontaneous restart by accident, wonderful bu they are rare.
Study, prepare, practice.