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Bangor Metro >  December 2006 >  CPR Revival

A person collapses in front of you clutching his chest in an apparent cardiac arrest and has appeared to stop breathing. Suddenly, you’re faced with a decision of not one but two lifetimes: Should I perform CPR? You’ve only seen CPR performed on television, or maybe in health class a thousand moons ago. What if you don’t do the mouth-to-mouth resuscitation part right?

It turns out you don’t necessarily have to. The Pine Tree Chapter of the American Red Cross is teaching a new and improved way of performing CPR, with the person delivering it giving more chest compressions to circulate blood faster—and absolve bystanders from having to perform rescue breaths. In guidelines released by the American Heart Association (AHA) last year, chest compressions alone have been determined to be lifesaving, because they bring oxygenated blood to the heart and brain until emergency responders arrive.
Orono-based author/publisher and respiratory therapy expert Dana Oakes has recently revised his bestselling reference book, Oakes’ Clinical Practitioner’s Pocket Guide to Respiratory Care, to include the new protocols. “After 50 years of research, the AHA found the old CPR method was not very effective,” Oakes says. Though the new guidelines were issued in 2005, he finds that even some in the medical profession are unaware of the new protocols, and he’s doing his part to spread the word that “you don’t have to give mouth-to-mouth to help save a life.”

Since last spring, the Pine Tree Chapter of the American Red Cross has been teaching new CPR standards. People taking classes are now learning to give two rescue breaths after 30 chest compressions, instead of after 15, as was previously taught. In Rockford, Illinois, emergency responders tracked their results from administering the new CPR techniques and found that they saved three to seven times more heart attack victims than they did using the older CPR protocols.

For a bystander untrained in CPR, the advice is to give chest compressions at a rate of 100 per minute. It may seem like a lot, but the rapid pace keeps blood flow going to the victim’s heart and brain until help arrives. Bystanders are also instructed to make sure the airways are unblocked, and to provide two rescue breaths after every 30 chest compressions, but not to make mouth-to-mouth breaths a priority.

According to the National Academies of Emergency Dispatch, 911 operators are being told not to instruct untrained bystanders in how to perform rescue breathing, and are instead asking them to perform chest compressions only. The area chapter of the American Red Cross is dispensing similar advice but encouraging everyone to learn CPR, says Patrick J. Walsh, health and safety program specialist with the Pine Tree Chapter.

“If a responder is unwilling, uncertain, unable, or untrained to give full CPR, continuous chest compressions should be given until emergency personnel arrive,” Walsh says. For infants, however, the CPR protocol for that age group remains unchanged. Rescue breathing for infants is vital, Walsh says, because most traumas are attributable to breathing problems such as choking, and not to heart ailments.

While Dana Oakes’ work is getting evidence-based improvements in respiratory care into the hands of healthcare professionals, he wishes more people from all walks of life knew about the lifesaving power of chest compressions.

“For every minute that there’s a delay in CPR, your chances of survival decrease by 10%,” Oakes says. “The typical emergency medical service doesn’t arrive for up to 10 minutes. The average is six minutes. By the time they get there, the survival rate is basically zero. If somebody had done something, some of those people might have lived. Just do chest compressions until the EMS shows up and the chances of that person surviving go up dramatically.”

For people interested in learning the full CPR methods, the Pine Tree Chapter of the American Red Cross offers training to both lay people and healthcare professionals across the Bangor metro region. If traveling or childcare is a problem, the American Heart Association offers a $30 instructional kit called “CPR Anytime” with an instructional DVD, booklet, and mini-mannequin so you and your family can learn CPR at home. (Visit www.cpranytime.org.)

With 75% to 80% of all sudden cardiac arrests happening at home, the need to perform CPR is not all about being a good Samaritan: The life you save may be your next of kin.

How to Admininster CPR

After calling or instructing someone else to call 911:

1.) Place the hell of one hand, with the fingers pointing outward, on the individual's breast bone in the middle of the chest.

2.) Place the other hand atop the first one in a palm-to-back fashion.

3.) Lock fingers.

4.) Keep arms straight.

5.) Push down with some force, 1 1/2 to 2 inches (Light compression will do little or no good.)

6.) Lift your hands slightly to allow the chest to recoil.

7.) After 30 compressions at a rate of 100 per minute, give two rescue breaths.  Repeat the cycle of 30 compressions and two breaths five times. Then chest for signs of life. Repeat until help arrives.

Lifesaving Surge

The American Red Cross has a dream: It envisions the day when at least one person in every household has been trained in first aid and CPR lifesaving skills, and that every American is within four minutes of an automated external defibrillator (AED).

An AED is a small, portable version of the machines we’ve all seen on TV medical shows—the ones that restart a stopped heart with an electric shock. But today’s AEDs, unlike earlier defibrillators, come with built-in help: About the size of a laptop computer, an AED actually analyzes the heart’s rhythm for any abnormalities and, if necessary, directs the rescuer to deliver an electrical shock to the victim.

Here in Maine, AEDs are increasingly found in offices, shopping malls, airports, sports arenas, schools, and other places where large groups of people gather and the risk of a sudden cardiac arrest incident is likely. Right now, more than 200,000 Americans die of sudden cardiac arrest every year, and that will increase as baby boomers age. Yet, according to Patrick J. Walsh, health and safety program specialist of the Pine Tree Chapter of the American Red Cross, up to 50,000 of these deaths could have been prevented—if someone had initiated what the Red Cross calls the “cardiac chain of survival.” (Call 911, administer CPR, and defibrillate early are the first three links in the chain.)

“Our mission is to prepare for and respond to emergencies,” Walsh says. “The more people who have first aid, CPR, and AED training, the safer we all are.” For more information about regional AED training opportunities or to schedule one to come to you, call 941-2903 or visit www.pinetree.redcross.org.