Did you know that modern CPR as we know it has been around for 50 years and has changed a few times over that time period? Those who have attended first aid courses often seem to think that it changes every time that they learn it which is not entirely true. The guidelines change on average every 5 years and yesterday (18 October 2010) new guidelines were published for the 50th anniversary.
Well over 30 000 people a year suffer a cardiac arrest but very few survive due to a variety of reasons, not least an unwillingness on the part of the general public to perform CPR.
In response to the new guidelines the BBC yesterday sensationally “warned” members of the public against giving what they archaically called the “Kiss of Life” unless they have been specifically trained to do so, stating that new guidelines have suggested that this is for the best. Only when you read through the whole article did you get to the part that said that if bystanders are trained in CPR techniques including mouth to mouth (Kiss of life), then this remains the best option.
In my opinion this type of sensationalist journalism, whilst trying to convey the message that any resuscitation attempt is a good thing, only serves to confuse and possibly will make those that have been trained uncertain about which route to take. As such the guidelines that were implemented in 2005 remain essentially the basis for the new current guidelines as seen below.
Let me clarify, those that have been trained i.e. First aiders and those people with a duty of care such as lifeguards and childminders should continue to do mouth to mouth ventilations as part of the sequence shown below (Adult Basic Life Support Algorithm) and are essentially the same as the 2005 guidance with a few minor modifications.
The following will explain why these modifications are necessary.
It is well recognised that initiating the Chain of Survival improves outcomes and leads to more people surviving cardiac arrest.
Basic CPR is unlikely to restart a heart that has stopped beating, but it does help keep blood flowing to the brain and helps keep that functioning so that when a defibrillator is used hopefully the heart will restart.
The chest compression component of CPR is therefore crucial in generating that blood flow. As such although the changes that have been made are fairly minimal from a first aid point of view, emphasis has been made on ensuring that good quality chest compressions are achieved in order to minimise the time spent without blood flowing around the body.
Compressions need to be faster and harder than before. Compressions should now be a rate of 100-120 per minute and should be pushed down to a depth of 5-6 cm.
Changes have also focused on the need to ask for an Automatic External Defibrillator (AED) if one is available when calling for help (999). Increasingly theses devices are being found out and about in the big wide world and should be used if at all available. Crucially you now do not have to be trained to have a go at one although obviously it helps. They have been designed to be as simple as possible. You turn them on & follow the instructions.
The newspapers and other media sources have picked up upon the guidance where someone is unwilling to or has never been trained in CPR. Then chest compression only CPR is acceptable, if the emergency services are a short distance away or if you are being instructed over the telephone.
The key thing to take away from all this is to try to save a life, because at the end of the day this is what matters. If you’ve had a little training, call 999 and perform CPR as 30 compressions :2 breaths and if you haven’t, dial 999 follow their instructions keeping on going until the ambulance arrives.
Hopefully you will never need to put your skills to use but if you are ever in such a situation I hope you will try.
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