History of CPR

For more than 50 years, CPR (cardiopulmonary resuscitation) has been advocated as a way to resuscitate cardiac arrest victims that can be learned and practiced by both professional healthcare providers and lay-persons or bystanders. The standard version now calls for alternating 30 hard pushes on a victim’s chest with two quick breaths into their mouth.

Recent Studies

Recent studies reported in the July 29 issue of the New England Journal of Medicine, however, show that a technique the American Heart Association has been promoting, “hands-only CPR,” may result in equal or higher survival rates than the traditional method when performed by non-professionals who are guided by a 911 dispatcher on how to correctly administer this simpler method.

Some experts believe that pumping is most important for adult cases, and advise doing chest pushes continually at a rate of 100 per minute while omitting the mouth-to-mouth breathing. Some suggest using the beat of the old disco song “Stayin’ Alive” as a guide.

Advantages

The reasoning behind the success of hands-only CPR for nonprofessionals is that more bystanders may be willing to attempt CPR if they get clear instructions from a dispatcher and if they don’t have to give mouth-to-mouth resuscitation, which is more difficult and often performed so poorly that it may do more harm than good.  Myron Weisfeldt, chief of medicine at Johns Hopkins and a CPR expert, identifies some of the issues in this podcast.

Approximately 310,000 Americans die annually of cardiac arrest outside hospitals or emergency rooms and only about 6 percent of those who are stricken outside a hospital survive. In contrast, one study reported that 12 percent survived when bystanders performed dispatcher-directed CPR with or without rescue breathing. Studies also show that 80 percent of bystanders will attempt the hands-only method, in contrast with 70 percent who tried the standard version.

Lessons Learned

The important lesson to be taken from these studies is that CPR performed by bystanders can definitely save lives and the easier hands-only method encourages more bystanders, who are not trained or competent in CPR with rescue breathing, to offer this life-saving assistance. It should be used for witnessed cardiac arrest for adult victims 8 years and older.

However, CPR courses should continue to teach rescue breathing, since it is important in cases of cardiac arrest due to obvious respiratory failure, which include most cardiac arrests in children and some in adults. Traditional CPR that includes rescue breathing is still, at this time, the method for use by professional healthcare providers in hospitals or emergency medical services (EMS) personnel in the field.

Search for CPR courses offered by the HCGH Wellness Center on our website.