Even people without CPR training can save the life of an adult
whose heart stops, and the American Heart Association has issued an
advisory urging everyone, trained or not, to act immediately in such
an emergency.
The procedure is simple: If you see an adult collapse after
having a heart attack, immediately call for help and then push hard
and fast in the middle of the chest continuously, until emergency
medical personnel arrive or an external defibrillator can be used.
Dr. Michael Sayre, the lead author of the recommendations, said
that the ideal would be 100 pushes a minute with enough force to
make the chest go down 2 inches, or about 5 centimeters, but, he
added, "there is no need to use a metronome and a ruler." Sayre is
an associate professor of emergency medicine at Ohio State
University.
CPR, or cardiopulmonary resuscitation, can more than double the
survival rate in cardiac arrest, but only about a third of people
who collapse get CPR from bystanders.
The advice does not apply to cardiac arrest in children, or that
due to drowning or drug overdose, which usually require rescue
breathing. Nor does it apply when the bystander does not see the
collapse, since it might not have been cardiac arrest.
But the exceptions, Sayre said, are only about a quarter of all
cardiac arrests. "We want people to act no matter what," he said.
"Doing chest compressions alone in these situations is better
than doing nothing," he said. "Even for children, the procedure
would be the same."
Chest compression keeps blood flowing, but it does not
reoxygenate the blood, as mouth-to-mouth resuscitation does.
The recommendations, being published in the April issue of
Circulation, are based on new studies of CPR techniques. They update
advisories published in 1997 and 2005.
Numerous studies in animals, and five others in humans, have
convinced experts that hands-only CPR from an untrained bystander is
usually as effective as CPR with mouth-to-mouth resuscitation
performed by a person trained in the technique.
There may be several reasons. Rescuers performing traditional CPR
take longer to start than those who use hands only, maybe because it
takes more time to prepare, intellectually and emotionally, for the
more complex and intimate procedure. Studies have also shown that
bystanders performing conventional CPR interrupted chest
compressions for longer than the recommended 10 seconds while doing
mouth-to-mouth resuscitation, resulting in fewer compressions.
Surveys suggest there may be reluctance to perform mouth-to-
mouth resuscitation because of fear of infection, but this is
probably a minor barrier. More commonly, CPR-trained bystanders cite
panic and fear of causing further harm as reasons for inaction. Such
fears are unwarranted.
"If you do nothing, the person will die," Sayre said. "And you
can't make them worse than dead."
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