Why did they change CPR?Here are some of the answers to the question: Why did they change CPR?
People study the results of using lifesaving skills constantly. Every five years a group of doctors reviews the science and determines if changes would save more lives.
(You can read all the details of the International Liaison Committee on Resuscitation 2005 Consensus on ECC & CPR Science and Treatment Recommendations
at:
http://www.americanheart.org/presenter.jhtml?identifier=3026177)
Here are a few quotes of interest:
For the single rescuer of an infant (except newborns), child, or adult victim, use a single compression-ventilation ratio of 30:2 to simplify teaching, promote skills retention, increase the number of compressions given, and decrease interruptions in compressions.
Checking the carotid pulse is an inaccurate method of confirming the presence or absence of circulation; however, there is no evidence that checking for movement, breathing, or coughing (ie, "signs of circulation") is diagnostically superior. Agonal gasps are common in the early stages of cardiac arrest. Bystanders often report to dispatchers that victims of cardiac arrest are "breathing" when they demonstrate agonal gasps; this can result in the withholding of CPR from victims who might benefit from it.
Treatment Recommendation: Rescuers should start CPR if the victim is unconscious (unresponsive), not moving, and not breathing. Even if the victim takes occasional gasps, rescuers should suspect that cardiac arrest has occurred and should start CPR.
There is insufficient evidence that any specific compression-ventilation ratio is associated with improved outcome in patients with cardiac arrest. To increase the number of compressions given, minimize interruptions of chest compressions, and simplify instruction for teaching and skills retention, a single compression-ventilation ratio of 30:2 for the lone rescuer of an infant, child, or adult victim is recommended.
Rib fractures and other injuries are common but acceptable consequences of CPR given the alternative of death from cardiac arrest. After resuscitation all patients should be reassessed and reevaluated for resuscitation-related injuries.
Emphasis on the quality of pediatric CPR is increased: "Push hard, push fast, minimize interruptions; allow full chest recoil, and don’t hyperventilate"
The pulse check was previously eliminated as an assessment for the lay rescuer. There is now evidence that healthcare professionals may take too long to check for a pulse and may not accurately determine the presence or absence of the pulse. This may lead to interruptions in chest compressions and affect the quality of CPR.
Foreign-Body Airway Obstruction
Four case reports documented harm to the victim’s mouth or biting of the rescuer’s finger (while using a finger sweep).
Chest thrusts, back blows/slaps, or abdominal thrusts are effective for relieving FBAO in conscious adults and children >1 year of age, although injuries have been reported with the abdominal thrust. There is insufficient evidence to determine which should be used first. These techniques should be applied in rapid sequence until the obstruction is relieved; more than one technique may be needed. Unconscious victims should receive CPR. The finger sweep should be used in the unconscious patient with an obstructed airway only if solid material is visible in the airway.
Higher airway pressures can be generated by using the chest thrust rather than the abdominal thrust.
Chest Compression–Only CPR
Consensus on Science
No prospective studies have assessed the strategy of implementing chest compression–only CPR. A randomized trial of telephone instruction in CPR given to untrained lay responders in an EMS system with a short (mean: 4 minutes) response interval suggests that a strategy of teaching chest compressions alone is associated with similar survival rates when compared with a strategy of teaching chest compressions and ventilations.
Treatment Recommendation
Rescuers should be encouraged to do compression-only CPR if they are unwilling to do airway and breathing maneuvers or if they are not trained in CPR or are uncertain how to do CPR.
The Red Cross policy is:
compression-only CPR is recommended for the following cases:
When emergency medical dispatchers are giving untrained bystanders instructions over the telephone; or
When bystanders are unwilling or unable to provide mouth-to-mouth rescue breathing.
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