Streamlined CPR rules make lifesaving easier

Associated Press

“Push hard, push fast” the next time you give CPR to someone having cardiac arrest.

In a radical departure from past advice, new guidelines from the American Heart Assn. emphasize chest compressions instead of mouth-to-mouth resuscitation. They recommend 30 compressions -- instead of 15 -- for every two rescue breaths.

“Basically, the more times someone pushes on the chest, the better off the patient is,” said Dr. Michael Sayre, an Ohio State University emergency medicine professor who helped develop the guidelines.

“We have made things simpler,” he said. “Push hard on the person’s chest and push fast.”


The streamlined guidelines, which were announced Nov. 21, should make it easier for people to learn CPR. Earlier rules were different for adults and for children and called on untrained rescuers to stop pushing the chest periodically to check for signs of circulation.

Now, the advice is the same for all ages -- 30 compressions -- and you don’t have to stop to check for improvement. What’s important is to keep the blood flowing.

Studies have shown that blood circulation increases with each chest compression, and it must be built back up after an interruption. “When you’re doing 30 of those compressions, then you’re giving more circulation throughout the body and the brain,” said Jennifer Khonsari of Texas CPR Training.

Sudden cardiac arrest -- when the heart suddenly stops beating -- can occur after a heart attack or as a result of electrocution or near-drowning. It’s most often caused by an abnormal heart rhythm. The person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing.


More than 300,000 Americans die from it each year. About 75% to 80% of all cardiac arrests outside a hospital happen at home, and effective CPR can double a victim’s chance of survival.

“The most common reason many people die from cardiac arrest is no one nearby knows CPR,” Sayre said. “For the bystander that witnesses a collapse, the main danger is inaction.”

More than 9 of 10 cardiac arrest victims die before they get to the hospital, the heart association estimates. “The bottom line is we think more people need to learn CPR,” said Mary Fran Hazinski, a clinical nurse specialist at Vanderbilt University Medical Center who also worked on the guidelines. “We have more and more evidence that good CPR works. We’re doing our best to increase the number of bystanders that learn CPR.”

Currently, about 9 million Americans a year are trained in CPR, the heart association says, but it has a goal of more than doubling that number in the next five years to 20 million.

The new guidelines also advise just one shock from a defibrillator before beginning chest compressions instead of giving up to three shocks first.

Those who have taken CPR in the past now have a chance to take a refresher course, said Dr. Ahamed Idris, professor of surgery and medicine at the University of Texas Southwestern Medical Center.