New CPR Technique!

Codger_64

Codger_64

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I believe it is important for all of us to know some basic first aid. How to perform CPR is one of the most basic and easy to learn, but not many take the time to learn it.

Every so often a new emergency medical techinque comes along which makes previous techniques obsolete. Continuous Chest Compression CPR, developed by the University of Arizona COllege Of Medicine show great promise in improving the usefulness of this lifesaving technique.


[youtube]EcbgpiKyUbs[/youtube]

Watch this simple video one or two times and you can perform this life-saving technique.

The main difference between this and the previous method is that there is no mouth to mouth breathing to interupt the chest compression (100 compressions per minute) Their research has shown that the uninterupted compressions provide better results, even without the artificial breathing, as blood continues to be pumped through the heart to the brain. The rebounding of the chest between compressions does provide some oxygen, though their research seems to show that it is most important to provide flow of already oxygenated blood, than to try to increase oxygenation, skipping compressions. Moreover, this technique requires no formal training and certification.

As both my father and grandfather died from heart attack at age 61, this is a subject I try to follow closely. It is on my mind every time I head out on a trail or launch my canoe alone. But I won't quit going. Perhaps this new technique will allow me to save someone else's life though. Maybe yours, or you might use it to save mine.
 
A good compact CPR mask with a one way valve is still essential first aid equipment. This is especially true if you have a two rescuer situation when one can do compressions and one can deliver breaths.

Do not fool yourself into thinking you need no training to perform a chest compression technique. I have monitored pulse in a patient's extremity while trained O.R. personnel delivered chest compressions during a code. Even a subtle change in technique can make a huge difference in the delivery of oxygenated blood.

Best advice; take an approved CPR course, stay certified with refresher courses every two years and carry a mask in your car, boat or first aid gear.
 
Actually, best advice is to not have a heart attack outside of a hospital cardiac care unit with a licensed cardiac surgeon and trained, fully equipped staff.

Second best is to hope that someone, one of the very few who took the time to go to classes and become certified as either an EMT or other first responder finds you quickly.

Next, we shall hope that one of the very few laypeople who come across our prone bodies has current certification in CPR and also happens to have special eqipment with them.

Next, and what most people have the greatest chance of happening while camping or hiking in the backcountry, is that a friend or passerby happens to have watched a video like the one above or read it described on a website and starts compressions immediately, training or no, while someone else calls 911 or goes for help.

Well, at least this is what the National Heart Association has been saying since 2008, and what I understand they will be including in their new CPR guidelines to be issued this year. It might be a good thing for people currently certified, particularly those whose jobs require it, to update their certification to reflect this change in the current CPR guidelines.

http://www.healthcentral.com/heart-disease/news-269331-98.html
http://health.usnews.com/usnews/hea...-only-resuscitation-ok-for-cardiac-arrest.htm
 
sorry, but I think this new chest compressions only is a crock of crap.

sure they say that it will provide oxygenated blood going to the brain for 10 minutes. But where I live the ambulance ride alone to the hospital is ~10 minutes. not to mention starting the CPR and waiting for the ambulance to show up, etc...

and I live in a town bordering the town containing the hospital.
 
I'm of two minds about this. I'm actually just getting ready to re-cert in CPR/First Aid for work and had this debate about an hour ago with my father. He was a certified EMT for over 25 years. He and I are both of the opinion that breathing works, but I can see the argument for cutting it out, as mentioned by Stealthchaser 13, in that, theoretically, compressions alone will keep oxygenated blood getting to the brain. I'm not convinced that it will help restore lung function. However, that said I think part of the reason people have tried this is because the public keeps getting dumber and can't figure out how to manage both breathing and compressions at the same time. At least that's what I've heard from more than one medical professional. I think that's a sad commentary on America. But you never know. It's always good to try new techniques and be up on the current ones. Thanks for the link Codger64.

Lagarto
 
Lagarto, please check back and let us know if your instructors are following this new technique, or if they are deciding not to update and why. I would be interested in knowing either way.

I am certainly not saying that people should not get CPR training. But neither should they stand around a downed man wringing their hands and refusing to help because they don't have a current certification paper. This method is more basic, more intuitive and, according to research, actually produces better results than the old way. Follow the links and read it. If it doesn't satisfy your curiosity, research it more.

Anyone who does not agree with the changes is free to refuse medical help/CPR that doesn't conform to your wishes/beliefs.

I remember well when conventional wisdom on snakebite was tight tourniquet, slash and suck. Some people still do this, refusing to change with modern medical technique.
 
The "new" guidelines are to encourage more public participation in providing CPR. The application of mouth to mouth has been a deterrent for many to become involved. So, compressions alone are still very beneficial and that much more if you can get someone to do it. Note the references to "lay people". I find it interesting the new focus and emphasis on no training requirement or legal issues. The CPR guidelines for healthcare/medical personnel are still compressions and breaths, but have been recently updated to 30 compressions to 2 breaths. CPR should be learned in a class where you practice on training devices to get the feel, placement, pressure and pace required, not to mention determining when to actually apply CPR. Classes can usually be found free or at very low cost. Check with your local Red Cross. Just go do it.
That being said, in the wilderness, the reality of survival in this kind of event is rather slim. When you take a class and practice the actual compressions, you soon realize that you cannot keep it up for long, certainly not long enough for help to arrive if you are anywhere near remote. I'm not saying don't do it, but just be aware you're in for a tough one and if you happen upon someone performing CPR and you have the training, offer to take over compressions to relieve them. Now, if you happen to have an AED handy, the odds go up considerably.

my .02
 
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glee said:
The "new" guidelines are to encourage more public participation in providing CPR. The application of mouth to mouth has been a deterrent for many to become involved. So, compressions alone are still very beneficial and that much more if you can get someone to do it. Note the references to "lay people". I find it interesting the new focus and emphasis on no training requirement or legal issues. The CPR guidelines for healthcare/medical personnel are still compressions and breaths, but have been recently updated to 30 compressions to 2 breaths. CPR should be learned in a class where you practice on training devices to get the feel, placement, pressure and pace required, not to mention determining when to actually apply CPR. Classes can usually be found free or at very low cost. Check with your local Red Cross. Just go do it.
That being said, in the wilderness, the reality of survival in this kind of event is rather slim. When you take a class and practice the actual compressions, you soon realize that you cannot keep it up for long, certainly not long enough for help to arrive if you are anywhere near remote. I'm not saying don't do it, but just be aware you're in for a tough one and if you happen upon someone performing CPR and you have the training, offer to take over compressions to relieve them. Now, if you happen to have an AED handy, the odds go up considerably.

my .02
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+1
Local Fire Dept's many times have classes free or close to it. If it's required from your employer, either they end up paying for it or you can later take a tax deduction for it because it's required.
I too recommend formal training. With knowledge of the human body one comes to know you can harm more than help a person having a "Cardiac Event".

my added 2¢
 
vrocco1 said:
You obviously didn't watch the video
Click to expand...

Actually, I watched it yesterday. Someone had posted it on paddling.net. I didn't think of my question until I saw it posted here this evening. I guess I either missed it the first time or simply forgot. Sorry. :o
 
lagarto said:
I'm of two minds about this. I'm actually just getting ready to re-cert in CPR/First Aid for work and had this debate about an hour ago with my father. He was a certified EMT for over 25 years. He and I are both of the opinion that breathing works, but I can see the argument for cutting it out, as mentioned by Stealthchaser 13, in that, theoretically, compressions alone will keep oxygenated blood getting to the brain. I'm not convinced that it will help restore lung function. However, that said I think part of the reason people have tried this is because the public keeps getting dumber and can't figure out how to manage both breathing and compressions at the same time. At least that's what I've heard from more than one medical professional.

Lagarto
Click to expand...

I agree. As with anything, while there are certainly newer and better methods, I've always been very conservative when it comes to proven life-saving techniques' efficacy.

I'm not totally close-minded though, but I think this merits further study.
 
I believe the principle is to deliver oxygenated blood to brain as quickly as possible. The uncirculated blood (CPR will supply the circulation) that just sits there has oxygen waiting to be delivered but won't be if it sits there. That is why it is more important to get it circulating than to interrupt chest compression to provide more ventilations (rescue breathing/breaths) than needed.

Chest compressions do not instantly circulate the blood it takes about 30 seconds for volumetric pressure to build up so every time compressions are stopped that is 30 seconds plus however long you spend providing breaths that the already oxygen depleted body and brain (CPR provides the bare minimum or even less depending on how good your compressions are.) is deprived of oxygen.

That in itself can add up to a lot of hypoxia (lack of oxygen.) In fact CPR guidelines for professionals have been changed recently in favor of more compressions than ventilations because of this. These changes are in my opinion positive and they are backed up by factual studies.

Now let me tell you something as far as ventilations are concerned they are required, but depending on your patients airway type, airway management can be, even for professionals, one bear of a task.

In my experience airway management situations usually do not conform to the ideal and an inexperienced lay person is almost certain to ventilate his patients stomach rather than the lungs which makes the situation worse since it can cause vomiting and aspiration (inhalation) of that vomit upon further ventilations (very bad.) An inflated stomach also pushes the diaphragm up against the lungs and heart making them less efficient in an already critical situation.

The statistics that come in show that most of the time lay persons wind up inflating the stomach when attempting ventilations so it was decided as far as inexperienced lay persons are concerned it is better to have them concentrate on chest compressions (the most important part) until professional help arrives than to have ineffective chest compressions due to interruptions for harmful inappropriately performed ventilations.

Airway management is one of the areas where experience and practice make a huge difference.

There is another name for "gasping" and "snoring" it's called agonal respirations or breathing it doesn't last very long and often often happens after the heart stops beating. It is the body's last gasps. Pulse checks can also be difficult for the inexperienced.
 
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When watching this video its important to hear them say w h e n this new technique is to be used, and w h e n not to used it. If you have knowledge enough to have a choice.

And always remember, when some one is dying, anything is better then nothing. They are dying, even if you kill then, they are not going to be any worse off.

I'll like to repeat this.

When some one is dying, anything is better then nothing.


You don't learn first aid and CPR in school ? colleague ?
We do in Denmark, seems a bit strange to me if you don't.
 
Hawkings said:
When watching this video its important to hear them say w h e n this new technique is to be used, and w h e n not to used it. If you have knowledge enough to have a choice.

And always remember, when some one is dying, anything is better then nothing. They are dying, even if you kill then, they are not going to be any worse off.

I'll like to repeat this.

When some one is dying, anything is better then nothing.


You don't learn first aid and CPR in school ? colleague ?
We do in Denmark, seems a bit strange to me if you don't.
Click to expand...


Yes a person in cardiac arrest is already dead and you are not going to kill him or her.

I totally agree I think is very shameful that basic CPR is not required grade school or even high school education in this country (US.)

To make matters even worse I remember trying find a basic CPR course in a NYC college I was attending and unable to. When I inquired college staff looked at me like I was from another planet. I had to go to the Red Cross in Manhattan.

On a positive note there is some progress as I remember seeing in the news (why should this be news? well I guess it is in America) some school districts in other states taking the initiative and requiring it for high school students.
 
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Scott Free said:
I wonder if the non-mouth to mouth applies to drowning victims to? :confused:
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The video which I just watched before editing this says for drowning victims you need rescue breaths as well and I agree but is a very good question that provides food for thought.

Cardiac arrest due to profound hypoxia (lack of oxygen) in a person with a good heart and good organs

verses

cardiac arrest due to the hearts failure to pump already oxygenated blood to the brain and organs.

There would be difficulties if his/her lungs are filled with water ventilations would be more difficult and inflating the stomach instead easier. That is something you wouldn't want to do. If the epiglottis clamped up (gag reflex) and there is no water or little water in the lungs you would still need some good airway management.

Either way if the blood is not pumped the oxygen will not be delivered to the rest of the body (vital organs such as the brain) even with good ventilations.


Learning CPR on a professional level and having good airway management skills would be the best bet.
 
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Codger_64: Thanx for bringing up an important topic.

A few points:
For an adult who arrests, FIRST call 911, THEN get an AED if close, THEN start CPR.

If people are nearby, definitely pick a person to call 911(and tell them to do it) , and another to get an AED (and tell them to do it). That way you can start CPR immediately. The reason for the order of things is that getting an ambulance on scene is _the most important thing_. The paramedics will bring a defibrillator (among other critical things), be able to transport the victim while providing care, and alert the hospital that they are coming. Even if the person converts to a normal heart rhythm in the field, they need to be in the hospital pronto.
The second most important thing is an AED, because that may potentially convert a fatal heart rhythm to a normal one (most likely the victims immediate problem), and change dead to not-dead. CPR is NOT going to fix the primary problem, but it will maintain blood flow (oxygenation of vital organs) until/if the fatal heart rhythm can be corrected. The quicker you start CPR, the better the person's chance of being not-dead (in the immediate time frame) and surviving/surviving with less serious problems (in the longer time frame).

Some CPR is better than none. I say this because presumably, even an untrained person who does some half assed CPR might help the victim be not-dead. That being said, TAKE A CPR COURSE. Learning to do CPR from watching reruns or ER, or from an internet video is no substitution for hands on learning with an instructor who can correct your technique (as a side note to this, the provided video had the first guy doing compressions at well below 100/min, and some guy later in the video was bouncing off the "victim's" chest).

Lagarto: "compressions alone will keep oxygenated blood getting to the brain. I'm not convinced that it will help restore lung function. "
I also have some reservations about compression only CPR, but at least for the public, stopping compressions for more than a few seconds can decrease a person's chance of being not-dead. As for "restoring lung function" - you are not going to do that outside a hospital whether you do CPR with or CPR without breaths.
 
Learning to do CPR from watching reruns or ER, or from an internet video is no substitution for hands on learning with an instructor who can correct your technique...

There's an interesting point right there. I'm so tired of seeing TV shows or movies, et al with incorrect CPR technique, even "medical" shows. Why not lobby producers to at least demonstrate proper technique that will expose their millions of viewers to have a clue about what to do correctly? Many shows now do this whole back story information about why things work the way they do. Why not make this a standard? As it is, it is a dis-service to the public as it is demonstrating incorrect methods and techniques. How many times have you seen someone pounding, and I mean wailing on someones chest? Ages ago, getting an FCC approval to broadcast required that you were doing so for the public good.
 
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Yeah, AHA(American Heart Association) changes their mind on what is effective every couple years it seems like. ACLS included. Nobody is gonna make the switch to this untill AHA does, as far as FDs, Ambulance, hospital, etc...

Airway management is important, but believe me, as far as mouth to mouth goes, without a BVM or CPR barrier, Id only go bareback on a kid. Unless you want a mouthfull of vomit. In this day and age you really need to worry about disease. For they lay person, activating 911 and getting an AED if one is availible is more important. Then worry about chest compressions.

The depth of compressions is important. They say if your not breakin ribs, you arent doin it right.

Ive seen people converted with only CPR. Ive converted people with only CPR. It does work. Not very often at all, next to never. It does work though.

This is what we use now, and let me tell ya, this thing is awesome. Ive gotten blood pressures while using it.

http://www.youtube.com/watch?v=MfrOdATkamg

Cool thing is, it really decreases the trauma. You can put your hand under the band while its working and not get it broken.

If you wanna learn CPR, take an AHA class. Hands on is key.
 
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