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Cardiopulmonary resuscitation


Hands-only CPR gains approval from Heart Association

Anyone who sees an adult collapse can save that person's life by doing two things: Call 911 and begin chest compressions, or hands-only cardiopulmonary resuscitation, according to the American Heart Association.

Monday's announcement from the organization helps simplify CPR for people who are not trained in the conventional method, or who are unsure of their abilities in performing the combination mouth-to-mouth breathing and chest compressions.

"It's as effective as traditional CPR ... when it's performed by any bystander," said Kristin Fettkether, communications director of the American Heart Association's Midwest Affiliate. "It's better to do hands-only CPR rather than nothing."

Hands-only CPR applies to bystanders helping adult, cardiac-arrest victims in a setting outside the hospital.

It involves pushing hard and fast in the middle of the person's chest, without giving the breaths. The person should continue doing the chest compressions until medical personnel arrives.

The association's CPR update appears in the new issue of Circulation: Journal of the American Heart Association. It's a clarification of the organization's 2005 guidelines for CPR, made by its Emergency Cardiovascular Care committee.

Hands-only CPR should only be done by a person who sees the adult collapse, Fettkether said. "Their blood and lungs contain enough oxygen to keep their other organs healthy for the first few minutes, as long as they're receiving high-quality chest compressions, with minimal interruptions, to pump blood to the heart and brain."

The American Heart Association says bystander CPR can double or triple a person's chances of survival. But fewer than one-third of out-of-hospital cardiac arrest victims receive it.

Kevin Teale, spokesman for the regional American Red Cross office in Des Moines, said the Red Cross has been advocating the compression-only CPR be used in a similar manner for about a year.

A Red Cross advisory committee came out with a position statement last May that doing just the compressions is an "acceptable alternative," Teale said. The committee would like to see additional studies done on the method.

"We take the position that for the best-case scenario that people do full-blown CPR, which would be compressions and breaths," he said.

The American Heart Association said that three separate, large studies published in 2007 showed no negative impact on survival when a bystander performed only the chest compressions.

Hands-only CPR should not be used for infants and children; adults who stop breathing because of respiratory causes such as drug overdose or near-drowning; or an unwitnessed cardiac arrest.

In those instances, the association said, conventional CPR is best.

The American Heart Association's previous recommendation stated that "lay rescuers" do compression-only CPR if they were unable or unwilling to provide breaths.

The update emphasizes that anyone can and should use the chest-compression only method, Fettkether said.

Some people may be hesitant to help for fear that they'll hurt the person or be sued, she said. "But they can't. You cannot be sued for performing CPR," under the Good Samaritan law.

Wanda Goranson has taught CPR for 17 years.

With more research, the number of steps in CPR has diminished, making it easier for people to learn how to perform the life-saving technique, she said.

Fifteen years ago, people had to learn more than 100 steps in order to pass a CPR class, said Goranson, training center coordinator at Iowa Health-Des Moines.

Doing only the chest compressions, she said, is something most people can do. "It's easy, it's simplified. I think it can help."

The Heart Association and Goranson encourage the public to get conventional CPR training.

"There is still a need for additional training," Goranson said.

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