Guidelines for Basic CPR Changed
The guidelines for basic cardiopulmonary resuscitation are being changed to make rescue efforts simpler, more effective and easier to teach.
Starting next year, the standard CPR course offered by the American Heart Assn. will no longer instruct people to search for a pulse before giving chest compressions to unconscious, nonbreathing and unmoving victims. The number of chest compressions per breath has been made standard for all adults. People who refuse to perform mouth-to-mouth respiration have the option of doing chest compressions alone.
The basic CPR course, which about 2.4 million Americans took in the last two years, will be shortened to two hours, compared to the three or 3 1/2 hours required now. The teaching and publicity of the new guidelines will also emphasize the importance of much more widespread dissemination of automatic heart-shocking devices known as defibrillators.
“Everyone here could easily learn to save a life,” Rose Marie Robertson, president of the American Heart Assn. and a physician at Vanderbilt University, said at a news conference Tuesday.
Traditionally, the heart association has been hesitant to change CPR protocols either frequently or extensively. This is partly because it doesn’t want to give potential rescuers--already hesitant to use CPR--the feeling they’re no longer competent.
The new 384-page guideline manual, which addresses not only CPR but also myriad other emergency interventions, tries to dispel that idea on its first page: “The new recommendations do not imply that care using past guidelines is either unsafe or ineffective.”
The revisions, the first since 1992, are by far the most extensive since guidelines for CPR by lay-persons were first published in 1974. They’re also the first produced by the collaboration of experts from many countries. Perhaps most important, they rely less on the opinion of experts, and more on data gained from randomized controlled trials of various rescue techniques, than did previous guidelines.
Sudden cardiac arrest (also called “sudden death”) claims about 225,000 Americans annually. The condition occurs when the heart suddenly ceases pumping blood effectively, blood pressure plummets and the victim loses consciousness. Without CPR or restoration of a normal heart rhythm, permanent brain damage is virtually inevitable within 10 minutes.
About 5% of people who suffer cardiac arrest outside of a hospital survive today. The heart association believes that could be increased to 20% if more people learn CPR and automated external defibrillators, which analyze a heart rhythm and can deliver a shock, are more available.
The guidelines are being published this month in a supplement to the journal Circulation. They will be taught to CPR instructors starting in September. The new protocols will be incorporated into CPR courses for the public starting in January.
