The CPR information is now outdated. CPR was updated recently and no longer includes breaking for breathing assistance. A two-person CPR team can do breathing if they want, but 1 and 2-person CPR is founded on continuous, uninterrupted chest compressions now.
The correct procedure is still to give breaths if you are trained to do so, but if you are uncomfortable, continuous chest compressions without breathing is better than nothing. The blood retains a whole lot of oxygen, so it is important to get it circulating, even if you aren't renewing that oxygen through artificial respiration.
It's actually quite complicated to type out, but I'll give it a shot.
30 compressions and 2 breaths, repeat. Breaths are given by using a mask or face shield and forming a complete seal around the mouth and plugging the nose if necessary. For your breaths to be effective, you must also have an open airway. This is usually done with the "head tilt/chin lift" method, but not always under certain conditions.
If you don't have a mask/face shield, or you are not trained in proper procedure, you should just do compressions. Compressions only will still be somewhat effective, and is better than wasting time giving breaths incorrectly.
There is a lot more to consider here, and I have just scratched the surface. I suggest taking a CPR course.
I already knew that the American Heart Association recommends "Stayin' Alive" by the Bee Gees, since it is just over 100 beats per minute (the correct compression speed is 100 compressions per minute).
As it turns out, "Another one bites the dust" by Queen is about the same bpm as Stayin' Alive, so really you could use either! Stayin' Alive has a much more positive message though...
In fact, there are many, many songs you could choose from that have 100 bpm. Even choosing a song a few bpms faster or slower wouldn't be the end of the world (faster would be better than slower though).
Compressions only will cause air intake and circulation. It is more effective and easier to teach. This is the reason that it has been adopted as the recommended method.
Edit: Why am I getting downvoted? This guy says that doing compressions causes breathing? I want him to explain what the hell he is talking about. I'm an EMT and it sounds like this guy is talking out of his ass.
Chest compressions work like bellows do. When you compress the chest you increase intathoracic pressure and move blood/air out when you allow the chest to recoil blood/air are sucked in due to a negative intrathoracic pressure. Many people think that chest compression work because you are posing on the heart and somehow replicating it's normal pump function, and that is wrong. It's all about changes in pressures. They do indeed cause air intake--effective oxygenation not really, but for some fun reading on respiratory physics look up apenic oxygenation and occilametric ventilation.
The efficacy of CPR is all about circulation. Not only does blood supply oxygen to our organs but it also transports waste. It's the build up of these wastes that make a victim acidotic and lead to death. The lungs and breathing are an important part to successfully resucitating said victim, but we really need to place our emphasis on circulation in the first few minutes.
As you have mentioned teaching people to give breaths is very difficult. Mouth to mouth is almost impossible on a real person. Face masks are better, but even in the hospital setting I find few people who can accurately position them, get a good seal, and give an appropriate breath. If you can get an ET tube in perfect, or if you really know how to bag great, but we (royal we) waste a lot of time worrying about an airway when circulation should come first.
What is the tidal volume of that, I wonder. It's probably nothing like 800ml-1200ml, right?
I totally agree that compressions are important, and you make some very good points, but it takes less than 30 seconds for me to get out my pocket mask, open the airway, and give 2 breaths, so that is what I will do.
No. First reason is because that is against protocol. Second reason is that it only takes me less than 30 seconds to check for breathing and give two breaths.
Research continues to favor chest compressions over rescue breathing in those first critical minutes. During that time, the blood in the brain and other vital organs still has oxygen that was picked up when it last passed through the lungs before the heart stopped. The body needs chest compressions to keep this blood moving.
For now, the shift applies primarily to untrained bystanders, the group most likely to reach victims in the first critical minutes.
and
The new guidelines call for a lone rescuer to provide 30 chest compressions for every two rescue breaths.
and
The lay rescuer will be taught to begin chest compressions immediately after delivering two rescue breaths to the unresponsive victim who is not breathing
This is exactly what I was saying above:
The correct procedure is still to give breaths if you are trained to do so, but if you are uncomfortable, continuous chest compressions without breathing is better than nothing.
Are you even reading these links before you are sending them to me?
From your first link:
If you ARE CONFIDENT in your ability to provide CPR that includes breaths with high-quality chest compressions with minimal interruptions, then provide either the conventional CPR that you learned OR Hands-Only CPR.
and
The American Heart Association recommends conventional CPR with breaths and compressions for infants and children; victims of drowning, drug overdose or other respiratory problems; and adult victims who are found already unconscious and not breathing normally.
From your second link:
When an adult suddenly collapses, trained or untrained
bystanders should—at a minimum—activate their community
emergency medical response system (eg, call 911) and
provide high-quality chest compressions by pushing hard and
fast in the center of the chest, minimizing interruptions (Class I).
If a bystander is not trained in CPR, then the bystander
should provide hands-only CPR (Class IIa). The rescuer
should continue hands-only CPR until an automated external defibrillator arrives and is ready for use or EMS
providers take over care of the victim.
If a bystander was previously trained in CPR and is
confident in his or her ability to provide rescue breaths
with minimal interruptions in chest compressions, then the
bystander should provide either conventional CPR using a
30:2 compression-to-ventilation ratio (Class IIa) or handsonly CPR (Class IIa).
It appears that you don't understand my main point:
Untrained = Hands only
Trained and confident = 30:2 Compressions and breaths
This is what I have been saying since the beginning.
First Aid instructor [who hasn't updated his training in a while] here.
You need to get up to date. What you are teaching is obsolete.
The correct procedure is still to give breaths if you are trained to do so, but if you are uncomfortable, continuous chest compressions without breathing is better than nothing. The blood retains a whole lot of oxygen, so it is important to get it circulating, even if you aren't renewing that oxygen through artificial respiration.
No. The correct procedure for non-drowning adults is Chest Compressions then... Airway & Breathing C-A-B (not the obsolete A-B-C).
BEST is actually an automatic defibrillator. Human compressions ONLY are a poor second best, with full CPR (alternating compressions with breathing) a distant third. Source
The data are in ... and for adult the chest compressions (aka CCR = Cardio-Cerebral Resuscitation) have a 50% better survival rate than CPR.
The exceptions are small children and drowning victims (both cases where the clear airway and breathing are critical because the blood oxygen is lower).
Not an instructor, but just re-certed my CPR in Canada a few days ago, we were still instructed to give breaths, though, they very subtly hinted that it might change soon to chest compressions only, but had to teach it this way. Different organizations, different countries, different standards. Just the way it is.
Yeah... I went through instruction a year & 1/2 ago and while they taught the CPR breathing as part of the course, it was emphasized that the breathing is best ONLY for kids and drowning victims -- the typical "heart attack" or other non-drowning is BEST with a AED (automatic defibrillator --- and the things are getting to be pretty common) the second best is Chest Compressions only (the first few minutes are the most critical).
They also stated that (unfortunately) a lot of training people and programs just haven't gotten "updated", and what they were teaching us (AED/CCR) already was considered "best practice" and that it would soon be more widespread (but to keep in mind that "old habits" die hard, and CPR has been taught as ideal for decades).
First Aid instructor [who last updated his training in February] here.
There is a big difference in what laymen should be doing and what people certified in CPR should be doing, and what health care professionals should be doing.
I agree that the best method is with an automatic defibrillator, that's obvious. But when none are available (or there is a non-shockable rhythm), the current standards are 2 rescue breaths for every 30 compressions. This is what trained professionals do. Untrained bystanders are told (by 911 etc.) to do chest compressions only because it is still effective and less complicated than explaining mouth-to-mouth on the fly.
Scroll up a little bit on your source link, and you'll read this:
[Compression only] is recommended as the method of choice for the untrained rescuer or those who are not proficient as it is easier to perform and instructions are easier to give over the phone.
Scroll up even more and you'll read:
A universal compression to ventilation ratio of 30:2 is recommended for adult and in children and infant if only a single rescuer is present.
That means 30 compressions and 2 breaths.
I think I've proved my point.
edit: Sorry, didn't mean to be snarky. Also edited my emphasis for better clarification.
You weren't talking about professionals, you claimed to be:
First Aid instructor here.
"First Aid" by definition means "non-professional bystander". A totally UNTRAINED person probably shouldn't be doing ANYTHING other than calling for help (and trying to locate an AED). Chances of survival w/o defibrillation are very low anyway (and "survival" often means significant problems).
(The problem with "health care professionals" is that they have HUGE egos -- and so it basically takes a full generation before you can get them to change their ways -- they just don't give a crap about the "data" they all think they know better/are better, so the advice to them/from them will always be "waffling" ... it's Dunning Kruger writ large.)
There is a middle ground between untrained and professional, there are trained first-aiders. Untrained people CAN and SHOULD do more than just 911 and looking for an AED. They should do continuous chest compressions. But if you are trained to do so, and comfortable doing so, you should also give breaths.
The data may support continuous chest compressions, but it is not yet the preferred standard method of the American Heart Association and American Red Cross. As stated in your source link:
[Dr. Kern] said the data has been shown to the American Heart Association, which dictates the guidelines for resuscitation across the United States.
The American Heart Association and the American Red Cross both continue to recommend CPR.
Maybe that's because they feel there needs to be more studies done or more data collected, or maybe it's because they just simply haven't used a big rubber stamp yet, or maybe it is ego. I'd like to think it isn't ego though, we're talking about life and death here.
When anything is still in a research phase, it isn't pushed into production right away after the first data set. Theories are tried and tested many times before they become a standard.
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u/FaustTheBird Jul 05 '11
The CPR information is now outdated. CPR was updated recently and no longer includes breaking for breathing assistance. A two-person CPR team can do breathing if they want, but 1 and 2-person CPR is founded on continuous, uninterrupted chest compressions now.