By Angela Hatton
http://stream.publicbroadcasting.net/production/mp3/wkms/local-wkms-933399.mp3
Murray, KY – CPR, the acronym for Cardiopulmonary Resuscitation, is one of the most common rescue techniques taught in the United States. The American Heart Association trains more than 12 million people annually in CPR. Many businesses and organizations require their employees to know rescue techniques. If you've ever taken a CPR class, you were probably taught to give a steady cycle of air and chest compressions. But new research suggests focusing on chest compressions only is more likely to save lives. As Angela Hatton reports, that could lead to a shift in the way we learn CPR.
In an office at the American Red Cross headquarters in Murray, CPR instructor Walt Blackburn goes through a training session. He uses what he calls a "human analog," a plastic mold of a person without arms or legs. Blackburn explains the initial recommended response when someone collapses.
"One of the first things we do is we check for consciousness. And the way that we do that is we tap them on the shoulder and we yell at them, Are you OK?'"
If that doesn't get a response, it's time to call 911. Blackburn says immediately after that, rescuers should start CPR. Blackburn says to check first for breathing.
"If we can tell that there is no kind of a breathing situation, we will pinch the nose, move the head back, *breath* *breath* and we will do two rescue breaths."
This is when chest compressions begin.
"Thump, thump, thump . . . etc."
Blackburn holds his arms straight, and presses two inches down each time. He does thirty before he stops to give another two breaths.
But new research says he should keep going. Chest-Compression Only CPR, also known as hands-only CPR, eliminates rescue breathing in most cases. A five-year study recently published in the Journal of the American Medical Association shows bystanders who used hands-only CPR had a five percent greater chance of saving a life than lay people who used traditional CPR. Emergency Physician Dr. Ben Bobrow headed the study. Bobrow explains why hands-only CPR may be more successful.
"Soon as the heart stops beating, the victim collapses, but the blood for a period of time is still oxygenated. And what we believe the most important component of CPR is circulating that oxygenated blood to the heart and the brain."
Bobrow says starting and stopping chest compressions reduces CPR's effectiveness. This study, which focused on lay people, is a follow-up to a study Bobrow and his team published two years ago. In that report, Bobrow tracked professional rescuers.
"We had our EMS providers focus on chest compressions for the first 8 minutes of resuscitation. And they significantly improved survival. In fact, they tripled the survival rate when they did that."
Bobrow says hands-only CPR isn't for everyone.
"If it's an adult who has drowned or has had some kind of choking or asphyxial arrest, in other words they had a breathing problem first, and then they went into cardiac arrest. They also need rescue breathing."
Bobrow says children and babies need rescue breathing too.
But organizations that teach CPR aren't ready to discard a method that's been successful for over fifty years. Calloway County Red Cross Director Jennifer Wilson says there's still a lot of research ongoing to investigate the advantages of hands-only CPR.
"But it's better to respond with something than nothing. And I think that's what the research is showing. We want that to be compressions to be started."
Wilson says that's why the national Red Cross plans to launch a new training class this spring, which will teach hands-only CPR. Wilson says the goal is to get five million more people trained in early response.
"We're hoping that stimulates them to know more about first aid and other kinds of response than just the compression only."
CPR Instructor Walt Blackburn says hands-only CPR may also appeal to people who are squeamish. Blackburn says the more we learn about germs and diseases, the less likely we are to want to get close to a stranger.
"And it's very difficult for you or me or anyone else to be able to do resuscitation with a mouth to mouth type situation. Even with a mask or a breathing barrier there, it's still a difficult decision to make."
The medical field is beginning to sway toward compression-only CPR. The American Heart Association has changed the order of steps in their 2010 CPR guidelines. They say to begin chest compressions before rescue breathing.