What’s New About Hands-only CPR?

When I received my CPR certification training earlier this year, our instructor described hands-only CPR as the method to use when a face shield (used for protection while giving rescue breaths) is unavailable.  She said that this was a new component of the training program.  It turns out that hands-only CPR is a relatively recent innovation that emphasizes moving oxygenated blood, instead of getting the victim breathing.

Hands-only cpr

The reasoning behind this change is that, since oxygenated blood is still plentiful in the body during cardiac arrest, it is most critical to keep blood flow to the brain and other vital organs during the critical initial response.

The sequence for hands-only CPR is:

  • Call 911
  • Start CPR

Effect of Cardiac Arrest on the Brain

Sudden cardiac arrest instantly causes blood flow to stop, starving the brain of oxygen. Brain cells start dying in about a minute, and serious brain damage occurs after about 3-4 minutes. Except in rare instances when the victim is younger and body very cold, after 10 minutes, many brain cells have died and the victim is unlikely to recover.

Maintaining Constant Blood Flow

Proponents of CPR without rescue breathing argue that uninterrupted chest compressions maintain the constant flow of oxygenated blood that’s critical to sustaining critical organs better than traditional CPR that is interrupted by rescue breaths.

More Bystander Involvement

Studies have found bystanders are reluctant to help because they’re afraid of doing something wrong or incorrectly. A study by the American Medical Association found that the rate of bystanders attempting any type of CPR increased from 28% in 2005 to 40% in 2009, with bystanders more likely to use hands-only CPR over traditional CPR.

Hands-only CPR can be more easily done by those with limited or no training being given instruction by an emergency dispatcher, thereby increasing the likelihood that CPR will be given during critical first minutes of a cardiac arrest and improving the chance of minimal injury to the victim.

Improving the Odds of Survival

The American Heart Association says that hands-only CPR is as effective as conventional CPR in the first few minutes of an out-of-hospital sudden cardiac arrest. (Conventional CPR may still be best for infants and children, adults who are found in cardiac arrest and victims of drowning or collapse due to breathing problems.)  While the AHA hasn’t changed their CPR recommendations to health providers, they are calling for more study to see if the existing recommendations can be improved.

The chances survival from cardiac arrest that occurs outside of a hospital vary from region to region but are typically very low (2-3% in New York City and Chicago).  That same American Medical Association study found that 13% of victims who received hands-only CPR survived, compared with 8% who received conventional CPR.

Any new approaches that might increase bystander participation and improve these survival statistics are worth researching and learning more about.  The initial information about hands-only CPR looks extremely promising.

(Photo: All Rights Reserved © 2012 American Heart Association)

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