Lives can be saved through chest-compression CPR - the hands-only portion of cardiopulmonary resuscitation - avoiding the need for mouth-to-mouth ventilation for adults who've collapsed, according to new guidelines from the American Heart Association.
The hands-only technique is a potentially lifesaving option for people not trained in conventional CPR or those who are unsure of their ability to give the combination of chest compressions and mouth-to-mouth rescue breathing.
The heart association issued the statement after reviewing a series of four studies, which demonstrated that hand compressions can sustain life until emergency personnel arrives.
Dr. Akram Boutros, president of the Long Island chapter of the American Heart Association, said there were several reasons behind the new stance. "About 10 years ago the University of Arizona Heart Center started teaching and advocating for compression-only CPR, but that was not validated until these four studies.
"However, we also know that many people are reluctant to help because they are afraid that they may be exposed to some disease," performing mouth-to-mouth resuscitation," Boutros added. "So the science and public's reluctance tipped the scales for the American Heart Association to develop these new guidelines.
"We may be able to double or triple the number of people who survive," said Boutros, chief administrative officer at St. Francis Heart Hospital in Roslyn.
The new CPR guidelines are published in this week's journal Circulation.
An estimated 310,000 adults in the United States die each year from sudden cardiac arrest, occurring outside a hospital or emergency room. Without immediate, effective CPR, a person's chance of surviving decreases 7 percent to 10 percent per minute.
"The upshot of these studies is that inaction kills," said Dr. Faiz Khan, vice chairman of emergency medicine at Nassau University Medical Center.
"Chest compression tends to have very positive outcomes without ventilation, and the public should have no hesitation in pushing hard and fast in the center of a collapsed patient's chest while 911 has been mobilized."
Although not part of the guidelines, Boutros recommended that Samaritans first try using an automated external defibrillator - AED - the devices mounted in airports, arenas, workplaces and other venues.
In a statement yesterday, the National Heart, Lung, and Blood Institute said AEDs and CPR are equally helpful for sudden cardiac arrest.
But Paul Pellegrino, a certified CPR instructor at St. Francis, emphasized yesterday that CPR is not difficult to learn. "You can probably do the class in about a half an hour, but it should be combined with full CPR," referring to mouth-to-mouth resuscitation.
Simplifying to hands-only CPR
Experts now believe an adult who suddenly collapses due to cardiac arrest has enough air in his or her lungs and blood during CPR and doesn't need mouth-to-mouth breathing.
If you see someone collapse...
...have someone call 911.
Position unresponsive adult.
Use an automated external defibrillator if available.
Keep CPR interruptions to a minimum.
Begin hands-only CPR with straight arms and forceful compressions at about 100 a minute.
Lift hands slightly after each to allow chest to recoil.
Take turns with a bystander until emergency medical services arrive.
SOURCES: University of Arizona Sarver Heart Center; American Heart Association
Every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can lessen this recurring loss by learning Continuous Chest Compression CPR, a hands-only CPR method that doubles a person’s chance of surviving cardiac arrest. It’s easy and does not require mouth-to-mouth contact, making it more likely bystanders will try to help, and it was developed at the University of Arizona College of Medicine.
"This video is worth sharing," said Gordon A. Ewy, MD, director of the UA Sarver Heart Center and one of the research pioneers who developed this method.