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Experts now recommend hands-only CPR
San Luis Obispo Tribune ^ | Mar. 31, 2008 | STEPHANIE NANO

Posted on 03/31/2008 7:17:03 PM PDT by neverdem

You can skip the mouth-to-mouth breathing and just press on the chest to save a life. In a major change, the American Heart Association said Monday that hands-only CPR - rapid, deep presses on the victim's chest until help arrives - works just as well as standard CPR for sudden cardiac arrest in adults.

Experts hope bystanders will now be more willing to jump in and help if they see someone suddenly collapse. Hands-only CPR is simpler and easier to remember and removes a big barrier for people skittish about the mouth-to-mouth breathing.

"You only have to do two things. Call 911 and push hard and fast on the middle of the person's chest," said Dr. Michael Sayre, an emergency medicine professor at Ohio State University who headed the committee that made the recommendation.

Hands-only CPR calls for uninterrupted chest presses - 100 a minute - until paramedics take over or an automated external defibrillator is available to restore a normal heart rhythm.

This action should be taken only for adults who unexpectedly collapse, stop breathing and are unresponsive. The odds are that the person is having cardiac arrest - the heart suddenly stops - which can occur after a heart attack or be caused by other heart problems. In such a case, the victim still has ample air in the lungs and blood and compressions keep blood flowing to the brain, heart and other organs.

A child who collapses is more likely to primarily have breathing problems - and in that case, mouth-to-mouth breathing should be used. That also applies to adults who suffer lack of oxygen from a near-drowning, drug overdose, or carbon monoxide poisoning. In these cases, people need mouth-to-mouth to get air into their lungs and bloodstream.

But in either case, "Something is better than nothing," Sayre said.

The CPR guidelines had been inching toward compression-only. The last update, in 2005, put more emphasis on chest pushes by alternating 30 presses with two quick breaths; those "unable or unwilling" to do the breaths could do presses alone.

Now the heart association has given equal standing to hands-only CPR. Those who have been trained in traditional cardiopulmonary resuscitation can still opt to use it.

Sayre said the association took the unusual step of making the changes now - the next update wasn't due until 2010 - because three studies last year showed hands-only was as good as traditional CPR. Hands-only will be added to CPR training.

An estimated 310,000 Americans die each year of cardiac arrest outside hospitals or in emergency rooms. Only about 6 percent of those who are stricken outside a hospital survive, although rates vary by location. People who quickly get CPR while awaiting medical treatment have double or triple the chance of surviving. But less than a third of victims get this essential help.

Dr. Gordon Ewy, who's been pushing for hands-only CPR for 15 years, said he was "dancing in the streets" over the heart association's change even though he doesn't think it goes far enough. Ewy (pronounced AY-vee) is director of the University of Arizona Sarver Heart Center in Tucson, where the compression-only technique was pioneered.

Ewy said there's no point to giving early breaths in the case of sudden cardiac arrest, and it takes too long to stop compressions to give two breaths - 16 seconds for the average person. He noted that victims often gasp periodically anyway, drawing in a little air on their own.

Anonymous surveys show that people are reluctant to do mouth-to-mouth, Ewy said, partly because of fear of infections.

"When people are honest, they're not going to do it," he said. "It's not only the yuck factor."

In recent years, emergency service dispatchers have been coaching callers in hands-only CPR rather than telling them how to alternate breaths and compressions.

"They love it. It's less complicated and the outcomes are better," said Dallas emergency medical services chief Dr. Paul Pepe, who also chairs emergency medicine at the University of Texas Southwestern Medical Center.

One person who's been spreading the word about hands-only CPR is Temecula, Calif., chiropractor Jared Hjelmstad, who helped save the life of a fellow health club member in Southern California

Hjelmstad, 40, had read about it in a medical journal and used it on Garth Goodall, who collapsed while working out at their gym in February. Hjelmstad's 15-year-old son Josh called 911 in the meantime.

Hjelmstad said he pumped on Goodall's chest for more than 12 minutes - encouraged by Goodall's intermittent gasps - until paramedics arrived. He was thrilled to find out the next day that Goodall had survived.

On Sunday, he visited Goodall in the hospital where he is recovering from triple bypass surgery.

"After this whole thing happened, I was on cloud nine," said Hjelmstad. "I was just fortunate enough to be there."

Goodall, a 49-year-old construction contractor, said he had been healthy and fit before the collapse, and there'd been no hint that he had clogged heart arteries.

"I was lucky," he said. Had the situation been reversed, "I wouldn't have known what to do."

"It's a second lease on life," he added.


TOPICS: News/Current Events
KEYWORDS: aha; cpr; firstaid; firstresponders; handsonlycpr; health; heart; medicine; rescue
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AP Photo
In this photo released by Jared Hjelmstad, Hjelmstad, right, of Temecula, Calif., visits with Garth Goodall at Rancho Springs Medical Center in Murrieta, Calif. Wednesday, February 27, 2008, days after Goodall collapsed while working out at a health club. Hjelmstad used hands-only CPR to keep Goodall's blood circulating until paramedics arrived and took over.

CPR. A lifesaving action.

Sarver Heart Center

1 posted on 03/31/2008 7:17:04 PM PDT by neverdem
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To: neverdem
In such a case, the victim still has ample air in the lungs and blood and compressions keep blood flowing to the brain, heart and other organs.

I can't help but wonder if this has been true all along then how could the medical profession be so off the mark as to recommend mouth to mouth in the past?
2 posted on 03/31/2008 7:22:26 PM PDT by Man50D (Fair Tax, you earn it, you keep it!)
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To: neverdem
We had an interesting thread earlier over here:

http://www.freerepublic.com/focus/f-news/1994595/posts

3 posted on 03/31/2008 7:27:31 PM PDT by buccaneer81 (Bob Taft has soiled the family name for the next century.)
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To: Man50D
I can't help but wonder if this has been true all along then how could the medical profession be so off the mark as to recommend mouth to mouth in the past?

We still understand how things work in the body very generally or not at all. They made their best guess. It makes sense that putting air in the lungs would be a good thing.

Then, their guess gets implemented and it works. So people use mouth-to-mouth for years. Then along comes AIDS and it takes years to notice that folks are skipping the mouth part and then more years to accumulate enough data to actually measure and make a determination whether one method or the other works best--you can't really do a controlled experiment. "OK, all those who volunteer to have a heart attack and get Push Only treatment, please move to the right side of the gym . . . " :)

So give 'em a break. They saved a lot of lives even though the technique they taught was overinclusive and kind of gross.

4 posted on 03/31/2008 7:31:01 PM PDT by ModelBreaker
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To: neverdem

Heh...I’m sure Newman and Jerry will be relieved to hear that...(Seinfeld - “The Pool Guy”)


5 posted on 03/31/2008 7:32:15 PM PDT by kromike
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To: buccaneer81

http://www.freerepublic.com/focus/f-news/1994595/posts


6 posted on 03/31/2008 7:34:32 PM PDT by steve86 (Acerbic by nature, not nurtureā„¢)
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To: neverdem
Thanks for posting. I sent it to everyone on my list who lives across the fruited plain.

Leni

7 posted on 03/31/2008 7:38:02 PM PDT by MinuteGal (I Love My Country More Than I Dislike McCain,.....Sincerely, A FRedhead)
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To: steve86

Thanks.


8 posted on 03/31/2008 7:38:34 PM PDT by buccaneer81 (Bob Taft has soiled the family name for the next century.)
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To: neverdem

This is fine until the O2 runs out in the lungs and the subject is brain dead. If the subject is turning blue, it is over with unless you can get air into them.


9 posted on 03/31/2008 7:41:20 PM PDT by Kirkwood (Ask me again tomorrow.)
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To: Man50D
I can't help but wonder if this has been true all along then how could the medical profession be so off the mark as to recommend mouth to mouth in the past?

Medicine is like any other field of learning. New knowledge is constantly being aquired, but we don't know what we don't know. I've must have learned six variations of CPR since 1969.

10 posted on 03/31/2008 7:46:05 PM PDT by neverdem (I'm praying for a Divine Intervention.)
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To: buccaneer81

Thanks for the URL.


11 posted on 03/31/2008 7:46:48 PM PDT by neverdem (I'm praying for a Divine Intervention.)
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To: steve86

Thanks for the link.


12 posted on 03/31/2008 7:47:41 PM PDT by neverdem (I'm praying for a Divine Intervention.)
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To: neverdem
Compressing and releasing the chest will cause some exhalation and inhalation if the airway is unobstructed. Apparently that is sufficient to sustain life, but it is hard for me to believe that the conventional technique is not superior if done properly. The conventional technique provides more oxygen to the patient, and increased gas exchange.

I wonder if these recommendations are based on real-world statistics, that reflect a substantial percentage of cases in which conventional CPR was done improperly.

This thread brings back some unpleasant memories.

13 posted on 03/31/2008 8:06:44 PM PDT by TChad
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To: neverdem

Thanks so much for this ping, neverdem.

I was with my Dad in the early 1980s, when he suddenly fell backwards with a massive heart attack.

This attack resulted in his death at age 56, and I tried, but I did not know CPR. I took a CPR class shortly after that, and blamed myself for a long time because I didn’t know what to do to save my Dad when this happened. I was young at the time, didn’t bother to learn this technique.

I rode with Dad in an ambulance to the ER, and was devastated as I watched them shock him in the back of the vehicle (the ambulance drivers tried to calm me by telling me it was such a massive heart attack nothing I did would have made a difference). He squeezed my hand one time as I stood beside him in the ER, and then it was over, he was brain dead, although he lived six days on life support.

It took me a long time to get over that. Everybody should know how to do CPR. And if the chest compressions alone can save a life, I think more people in the middle of a crisis will be able to respond, and know they did everything possible to save a life.


14 posted on 03/31/2008 8:06:55 PM PDT by girlangler (Fish Fear Me)
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To: neverdem

Thanks so much for this ping, neverdem.

I was with my Dad in the early 1980s, when he suddenly fell backwards with a massive heart attack.

This attack resulted in his death at age 56, and I tried, but I did not know CPR. I took a CPR class shortly after that, and blamed myself for a long time because I didn’t know what to do to save my Dad when this happened. I was young at the time, didn’t bother to learn this technique.

I rode with Dad in an ambulance to the ER, and was devastated as I watched them shock him in the back of the vehicle (the ambulance drivers tried to calm me by telling me it was such a massive heart attack nothing I did would have made a difference). He squeezed my hand one time as I stood beside him in the ER, and then it was over, he was brain dead, although he lived six days on life support.

It took me a long time to get over that. Everybody should know how to do CPR. And if the chest compressions alone can save a life, I think more people in the middle of a crisis will be able to respond, and know they did everything possible to save a life.


15 posted on 03/31/2008 8:07:47 PM PDT by girlangler (Fish Fear Me)
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To: neverdem

bump for later


16 posted on 03/31/2008 8:10:02 PM PDT by gibsosa
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To: neverdem

This ruins my CPR fantasy involving Eva Longoria...


17 posted on 03/31/2008 8:12:15 PM PDT by lmr (The answers to life don't involve complex solutions.)
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To: girlangler

>>I think more people in the middle of a crisis will be able to respond, and know they did everything possible to save a life.<<

You said it all!


18 posted on 03/31/2008 8:18:18 PM PDT by B4Ranch ( Rope, Tree & Traitor; Some Assembly Required || Gun Control Means Never Having To Say I Missed You)
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To: neverdem

ah nothing like PC CPR now...First thought: suppose the victims airway is obstructed by vomit or detritus ?...you have to make sure the airway is clear...all the hand pumping isn’t going to get oxygen into his or her system if the airway is obstructed...for CPR you need Oxygen flow plus Blood flow to keep the victim going..

The article does point out that Oxygen/air is neeed, but it is almost misleading if people miss some key points and say oh ok, hands only is ok now...Thats only if the patient can breath freely


19 posted on 03/31/2008 8:19:33 PM PDT by billmor
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To: lmr
This ruins my CPR fantasy involving Eva Longoria...

You really do not want for that fantasy to come true. There is absolutely nothing erotic about a woman who is doing her best to die on you.

20 posted on 03/31/2008 8:30:04 PM PDT by TChad
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