Recent changes in CPR
Simplification may encourage bystanders to attempt CPR in an emergency
Over the past two years I have been approached by many professionals in the recreation industry with questions about why CPR changed, who made the decision to change it, and what we can expect in the future.
The American Heart Association (AHA) holds the Resuscitation Science Symposium and Emergency Cardiovascular Care Update (ECCU) every year. It is here that the epidemiology and current research is reviewed and recommendations for changes made.
Going into the last Resuscitation Science Symposium, the data they looked at indicated the following about CPR:
- To be most effective, CPR must be started as soon as a person collapses.
- Best outcomes rely on prompt CPR, a call for professional help, and use of an AED.
- CPR is only performed in one-third of witnessed cardiac arrests.
- Even when performed by professionals, CPR is generally not done correctly.
- Overuse of airways and excessive ventilation results in interrupted compressions and decreased cardiac output with a corresponding drop in coronary perfusion.
- Compressions are performed too slowly and shallow to be effective.
The goal of the most recent changes? Simplification
According to Pam Howland of the AHA and Kerry Swinney, Emergency Medical Services Coordinator for Truckee Meadows Community College, research indicates that lay people or bystanders were reluctant to perform CPR because they felt it was too complicated and they were afraid of doing it incorrectly.
In an attempt to address this issue, the 2005 Guidelines for CPR simplified the sequences and eliminated many of the differences in technique between infant (excluding newborns), child and adult victims and implemented a “universal” compression ratio of 30:2 for all single rescuers of adult, child and infant victims. Additionally, the AHA eliminated some skills from the lay person curriculum. For example, rescue breathing without compressions will no longer be taught. The AHA wants to make CPR easier to remember and perform by the lay person or bystander so that it will be performed when it is needed.
No doubt more CPR changes will come down the pipeline and we all have to be ready to retrain and retool ourselves and our staffs. CPR will remain the mainstay for the foreseeable future; as Kerry Swinney states, “The blood has to circulate, and AEDs are most effective if used in the first 6 minutes of an emergency and in conjunction with CPR.”
For more information on the “new CPR,” including more detailed explanations of the changes, check the American Heart Association website.