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    Do CPR the right way: 5 things everyone needs to know

    The American Heart Association announced today new recommendations for the way CPR is performed. The small change could make a big difference in the lives of people suffering from cardiac arrest, the organization says.

    For nearly 40 years, CPR guidelines have trained people to follow these simple A-B-C instructions-tilt the victim's head back to open the airway, then pinch their nose and do a succession of breaths into their mouth, and finally perform chest compressions.

    But now, the AHA says starting with the C of chest compressions will help oxygen-rich blood circulate throughout the body sooner, which is critical for people who have had a heart attack. With this shift, rescuers and responding emergency personnel should now follow a C-A-B process-begin with chest compression, then move on to address the airway and breaths. This change applies to adults, children, and babies, but does not apply to newborns.

    The revision is a part of the 2010 emergency cardiovascular care report published by the AHA., an organization that reviews its guidelines every five years, taking into account new science and literature. Although the changed procedure will take some time to reach what Monica Kleinman, the vice chair of the AHA's Emergency Cardiovascular Care Committee, calls "front-line people", there is a plan in place to implement the recommendations as soon as possible to their training network, medical staffs, and first-responders.

    "The sooner chest compressions are started, the more likely there will be a better outcome," Kleinman announced. "Studies performed in labs as well as large-population studies have shown that people do better if they get chest compressions within four minutes."

    That four minutes is the amount of time it could take for emergency crews to rapidly respond, Chicago firefighter and CPR instructor Kelly Burns notes. Until then, he stresses that any CPR bystanders perform can make a difference.

    "Early activation is critical," Burns says, especially in cities where traffic and walk-up buildings can slow even the fastest respondents during a trauma where every minute counts.

    When someone needs CPR, the very best reaction is a quick one, he says.

    "In a perfect world, someone else calls 911 while you start chest compressions on the person in need," he advises. According to Kleinman, however, only about one-third of victims of cardiac arrest get assistance from bystanders.

    Despite changing guidelines, outdated training, or any confusion in the moment, Burns says that no one who tries CPR is faltering.

    "People are reluctant to jump in and help, especially if the person is not a family member or friend," Burns observes on a weekly basis. "The only mistake a civilian can make in these situations is waiting and not doing anything at all."

    To that end, the new AHA guidelines are meant to help anyone who encounters this kind of emergency-the idea being, if they know better, they will do better.

    5 potentially life-saving notes to remember about the new C-A-B method of CPR:

    1. There are no mistakes when you perform CPR.
    "One thing most people don't know, " Kleinman says, "is that there is almost nothing you can do [during CPR] to harm a person in cardiac arrest except delay responding."

    Starting with chest compressions is now viewed by the AHA as the most effective procedure, and all immediate assistance will increase the chances the victim will survive with a good quality of life.

    If one person calls 911 while another administers CPR, as Burns recommends, emergency operators will give informed instructions over the phone as well as dispatch aid to the scene.

    2. All victims in cardiac arrest need chest compressions.
    The AHA asserts that people having a heart attack still have oxygen remaining in their lungs and bloodstream in the first few minutes of cardiac arrest. Starting chest compressions first thing pumps blood to the victim's brain and heart sooner, delivering needed oxygen. This new method saves the 30 seconds that people performing CPR used to take to open the airway and begin breathing under the old guidelines.

    3. It's a myth that only older, overweight men are at risk for a heart attack.
    "Equal numbers of women and men have heart attacks," Kleinman reports. Sufferers are primarily adults.

    Although infants and children are far more likely to require CPR due to accidents than cardiac arrest, it is important to know how administer care to them. (You can learn how to perform CPR on infants and children with this kit produced by the AHA or by signing up for one of their training sessions.)

    4. Nearly all cardiac emergencies occur at home.
    "Ninety percent of events take place at home. If you perform CPR in your lifetime, it's probably going to be for someone you love," Kleinman reveals.

    5. Training is simpler and more accessible than you think.

    Learning CPR has never been hard, Kleinman says, but guideline changes in the last ten years have reduced the number of steps and simplified the process even more.

    Traditional CPR classes (listed here on the AHA website) are accessible for many people at local schools and hospitals.

    Kits are also available to complete in the privacy of your own home or workplace. Kits available through the AHA include inflatable, disposable mannequins and a training DVD.

    "Anybody can learn to do CPR. It's clearly important for saving lives, and now it is easier than ever," Kleinman asserts.


    Have you ever administered or received CPR? Would you jump in to the C-A-B method if you saw a person in need?



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    376 comments

    • R  •  1 year 7 months ago
      If the airways obstructed than maybe they just choked on something in which compressions could lodge the obstruction further down their air passage way.
    • A Yahoo! User  •  1 year 7 months ago
      A "heart attack" is not the same thing as cardiac arrest. CPR is needed for cardiac arrest, not a heart attack. Better clarification by the author is needed, especially when making statements such as "But now, the AHA says starting with the C of chest compressions will help oxygen-rich blood circulate throughout the body sooner, which is critical for people who have had a heart attack."
    • Joe R  •  1 year 7 months ago
      To answer some of the commments made previously. Starting with compressions makes perfect sense since each compression also has a related circulation of oxygenated blood from residual sources. Remember the anti choking technique for a pregnant woman or very large man? It was to give chest compressions because when compressed the chest forces air out of the lungs and the relief of pressure creates a slight negative pressure which translate into a complete breath. With CAB the victim will receive a mini ventilation with each compression if the airway is open. If closed, the residual will be sufficient until the airway can be established.

      Another point was made about checking for a pulse. The current guidelines only teach health professional to check for a pulse. The proper technique for everyone else is to look for signs of circulation.
      Many "Professionals" still do not check long enough or even properly.

      Joe Rousseau
    • nickr_2240  •  1 year 7 months ago
      Airway Breathing CIRCULATION not chest compressions, this makes no sense because you would want to hook a heart attack patient up to an EKG if he has no pulse right?
    • Boo  •  1 year 7 months ago
      CPR is easy to learn and pass. It's like a written test you pass. I passed the examine back in high school. Never did renew though.I should...
    • Sweet Talkin Hippy  •  1 year 7 months ago
      I took my AHA CPR training 4 years ago, and they were teaching this C-A-B method...for exactly those same reasons...I don't think it's that new.
    • Beth  •  1 year 7 months ago
      hmm...
      they neglect to mention that first you have to check for a pulse and breathing...
      or maybe they figure the average reader already knew that...
    • Tim  •  1 year 6 months ago
      To Patrick - I was taught that the body contains a reserve of 7 minutes of oxygen - so the basic principle that compressions are more important than the 2 breaths is valid. Also taught that its better to squeeze the victims thumb and check that colour returns than feeling for a pulse. But yes, it is important to check whether they are breathing/moving blood around the body first.

      For untrained people - I found it helpful to learn that 99% of victims requiring CPR will never resucitiate after CPR like we see on Baywatch, the key is to keep the blood flowing to avoid brain damage till the experts take over.
    • A Yahoo! User  •  1 year 7 months ago
      My name is Robert I didn't know I was on my wifes account.
    • James  •  1 year 7 months ago
      Sounds good. Anyone can save a life.
    • A Yahoo! User  •  1 year 7 months ago
      In 2008 I suffered Sudden Cardiac Death while out riding my bike in Salem, Va. and, well...I died on the side of the road. The electrical signal between my brain and my heart got "confused' (or so doctors think) and my heart stopped completely and I fell lifeless on the side of the bridge. A passerby called 911. She and the first responding officer began initial CPR-at this point I had been without oxygen for over 3 minutes. A Cardiac Surgeon on his way into Salem, on his day off, passed by the scene, and when he happened to look back in his rear view mirror, saw the officer and bystander over me attempting CPR. He knew God would strike him down if he didn't stop and offer help. Cheryl, the woman who was helping the officer, remembers Dr. Rowe running up the hill and shouting, "You're not doing it fast enough!" - Meaning that the compressions that they were performing weren't fast enough to get the needed oxygen rich blood to my vital organs. It had been over 5 minutes that had passed that I had been without oxygen. Dr Rowe looked at my completely blue body, felt no heart beat, heard no breath sounds, and thought- "Should I even try to bring this girl back?" But, God was there with him, so he took a leap of faith and took over the CPR. Dr. Rowe, my angel, performed 100 compressions a minute for 8 minutes without stopping. A miracle in motion. AHA suggests that you pass off after a few minutes because CPR is so exhausting and your ability to perform it effectively decreases the longer you do it. Not for Dr. Rowe, who also happened to be a tri-athlete Cardiac Surgeon. 5 of Salem's Senior EMS Firefighters happened to be coming back from a conference in the back of an ambulance when the 911 call went out for me. They were less than a 1/2 a mile away from where I was. Later they would realize they had passed me while I was still riding. Once they arrived and assessed the situation, which wasn't good, they administered a series of 3 external shocks with an AED, with no response but a lot of chicken scratch-like lines. They stopped to determine if it was time to 'call it'. To say that they had done all that they could do. It was then that I took 2 big gulping breaths on my own to say, "Hey guys, I'm not through here yet!" They would give me 2 more shocks before they could get a sustainable heart beat...the story continues and we have a book called the Mechanics of a Miracle that goes into the rest of the crazy awesomeness of what happened to me. And trust me, there's a TON more awesome stories to share. We're just searching desperately for an agent! So if anyone knows one who might be interested, send them my email ktmcintyre76@hotmail.com! Thanks!
    • Wyndell  •  1 year 7 months ago
      I readily accept the C-A-B proceedure, but I am concerned that there was no caution about being sure not to break the Sternum when performing the compressions. Have the rules also changed on this?
    • A Yahoo! User  •  1 year 7 months ago
      2 years ago I suffered sudden cardiac arrest if it wasn't for the action of my sister and cousin I would not be here today. As soon as I went into SCA they started CPR, if they didn't start CPR right away I wouldn't have survived. The chest compressions are more important then taking the time to check the pulse or watch for breath sounds. Think about it how long are you supposed to check for a pulse? 5 to ten seconds how long are you supposed to check a pulse? 5 to 10 seconds. Now by the time you figured out there is no pulse or breathing assuming you did not witness the arrest they may have been down for 4 to 6 minutes, which if you know how long your brain can go without oxygen taking 20+ seconds adds to that 4 to 6 minutes it takes for the brain to die because it doesn't have oxygen. I strongly urge you to take a CPR class because you never know when you may need to use it. I needed and I'm here today to tell you CPR saves lives!
      Sudden Cardiac Arrest Survivor 6/21/2008
    • sukisue  •  1 year 7 months ago
      Make up your mind people! Its like we can't keep up w/what they decide. Its hard for people to keep up with what they say, first its abc then its the amount of compressions....how are people suppose to know what to do in a an emergency situation they won't be sure how or what they are suppose to do.....I figured that they would eventually do something like this when they changed the compression rate. Does this mean that those of us who have our certification need to get recertified?
    • Dharma  •  1 year 7 months ago
      A-B-C, then Chest Compressions Only, now C-A-B. Keep changing it and no one is going to know what to do! Keep it simple.
    • LisaS  •  1 year 7 months ago
      Well, notice how they FAIL to tell us exacgly WHERE on the chest to give these compressions, how many to give in sequence. A simple instructive sentence to undergird the whole article.

      If I were faced with this situation, I would try to intervene, but the one part that would concern me is the location on the sternum for the compressions, and how to conduct them.

      Some writers amaze me with their lack of perceptive communication.....
    • Bobby  •  1 year 7 months ago
      The terminology used in this article will cause people to die. CPR is NOT done for a heart attack, it is done for cardiac arrest. Why is this important? Because if you equate heart attack with needing CPR and grandpa is sitting there talking about his chest pain, denial gets even easier. They have equated heart attack to needing CPR and so gramps can't be having one thereby delaying his trip to the hospital. Delay in seeking treatment for a heart attack is already enough of a problem. Frequently the heart attack & cardiac arrest are simultaneous but not always.
    • Donna  •  1 year 7 months ago
      With all the recent research going into this, it's a smart change. The amount of oxygen that gets into a person's system with mouth to mouth is negated by the time it takes to do it. While you're messing around with the airway and giving breaths, blood pressure in the coronary arteries is falling. It's not about bringing the person back to life, it's about keeping their heart muscle perfused enough so that when first responders arrive, they can give medications and defibrillate. I work on an ambulance in a small town and we implemented this CPR method last year as a clinical trial. We've been getting very good results with it.
    • tyson  •  1 year 7 months ago
      So many MDs and nurses posting comments its amazing.
    • Henry G. L  •  1 year 7 months ago
      What is the ratio, still 30:2?

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