Chest Compressions performed on cpr dummy

Jan Wolak

Cardiopulmonary resuscitation (CPR) saves lives. Yet many people remain untrained in basic CPR and are less likely to act as a result.

A recent study concluded that survival rates for people who experience sudden cardiac arrest increase when 911 dispatchers guide callers in identifying cardiac arrest victims and then coach the callers to begin CPR and continue until help arrives. Of the more than 380,000 Americans who are assessed by emergency medical technicians for sudden cardiac arrest each year, only about one in 10 of those who suffer cardiac arrest outside the hospital setting survives.

Early CPR is one of the links in the cardiac arrest ‘chain of survival’ identified by the American Heart Association (AHA), emphasizing the importance of basic knowledge regarding this life-saving procedure.

Recognizing when CPR is needed is the first step. “Previously, people were asked to check for a pulse first. This is no longer the case, as many people are unsure of how or where to check for a pulse. Instead, we ask people to check for signs of breathing or other signs of life, like responsiveness or a normal skin color. If they are breathing, conscious or have a normal skin color, then CPR should not be started. However, any victim who is suddenly not breathing normally or is suddenly unresponsive and blue should have CPR begun on them immediately,” says Dr. David Tan, a physician specializing in emergency medicine and chief of the EMS section for Washington University Physicians.

“Victims of cardiac arrest may have ‘gasping’ respirations that laypeople misinterpret as ‘breathing,’ but it is certainly not ‘normal breathing,’ ” Tan continues. “It should be emphasized that people who are suddenly unresponsive and not breathing normally—even if they have occasional ‘gasping’—should have CPR begun immediately.”

Once CPR is initiated, don’t stop. CPR should continue until emergency medical personnel arrive, the patient recovers, or the person performing CPR is completely and utterly exhausted, advises Dr. James Wessely, medical codirector of the St. Luke’s Hospital emergency department.

Some people are concerned or confused about the technical aspects of performing chest compressions along with mouth-to-mouth resuscitation. However, ‘hands-only’ CPR has become standard practice. After calling 911, CPR should be initiated by pushing hard and fast in the center of the chest. This technique is as effective as alternating chest compressions with mouth-to-mouth breathing for sudden cardiac arrest victims.

“Hands-only CPR may not be as effective as CPR with mouth-to-mouth breathing for certain situations, like drowning or drug overdose or for children less than 8 years old,” Tan notes. “Also, for victims who are found unconscious and not breathing where the collapse was not witnessed, CPR with rescue breathing might be more effective than handsonly CPR.”

Although most people can perform hands-only CPR without formal, in-person training, CPR classes remain beneficial. “It is important to take at least one class in CPR to get the basic idea. People do better if they have refresher classes,” Wessely says.

CPR classes are available periodically at most area hospitals. Additionally, smartphone users can purchase ‘Pocket First Aid & CPR,’ an app created by the American Heart Association, and download the AHA’s free ‘Hands- Only CPR’ app.