According to the American Heart Association, research has shown that bystander CPR can more than double a person's chance for survival. However, the prevalence of bystander Cardiopulmonary Resuscitation remains low in most areas of the country. Common reasons cited for not initiating CPR when seeing someone experience cardiopulmonary arrest include concerns about mouth to mouth contact (giving rescue breaths), fear of doing something wrong, and panic.
Also known as hands-only CPR, compression-only CPR is a CPR in which continuous compression is given and no mouth to mouth breathing or rescue breaths. According to the American Heart Association, it is the most effective form of CPR for adults and teens. This is because it is easy to learn and remember, increasing the likelihood of surviving breathing and cardiac emergencies, airway obstruction, and drug overdose.
How to perform compressions only CPR?
Here's the proper way of performing high-quality chest compressions according to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care:
1. Position the victim on their back on a firm surface.
2. Place your hand in the center of the victim's chest, interlocking your fingers.
3. Use your body weight to perform chest compressions at a rate of 100-120 compressions per minute.
4. For effective compressions, allow the chest to return to its normal position after each compression
5. Keep performing chest compressions until the victim begins to breathe on their own or emergency medical assistance arrives.
Efficacy of Chest compression-only CPR
It's a proven fact now, not only by research studies but also by real-life data, that people around the victim of out of hospital cardiac arrest are reluctant to do rescue breathing. The primary cause for this hesitation is that they fear catching diseases from the victims, and even trained people fear that they cannot perform it correctly. The ratio of casualties who collapsed in public due to cardiopulmonary arrest is 1 out of 5 who received CPR from an untrained bystander.
According to a publication in The Journal of the American Medical Association on Oct 6, the study concluded that adult cardiac arrest victims had 60% more chances of survival than those who didn't receive appropriate CPR in a mall or a restaurant. American Health Association is a leader in training individuals for CPR, using rescue breathing as an important part, and has updated its stance on training after the research in 2008.
After investigation, it is found that chest compressions-only compressions are more efficient than giving both chest compressions and mouth to mouth breath for a patient receiving from a bystander. Continuous chest compressions are helpful in resuscitating until the arrival of Emergency Medical Services team reaches the victim of out of hospital cardiac arrest.
Why is Hands-only CPR better?
There are several reasons for preference for chest compressions:
- Giving mouth to mouth breathing while performing CPR halts blood circulation to vital body parts like the brain, which is regenerated by CPR chest compressions.
- During out-of-hospital cardiac arrest, victims generally inhale oxygen more rapidly than before they collapse, so they have enough oxygen supply in their blood and need blood circulation more than oxygen. In this case, continuous chest compression can do a lot in the resuscitation by bystanders.
- Chest compressions only let some air be inhaled passively during chest recoil, which, although it supplies a lesser amount, still provides oxygen.
It's been a while since proven that those who immediately received shocks with defibrillators soon after they collapsed with a cardiac arrest had survived mostly. This fact has led to the availability of AEDs (Automatic External Defibrillators) at several locations, but still performing CPR is better until AED or the emergency medical services arrives. The rate of compressions should be 100 beats per minute while performing CPR.
Chest Compressions-Only CPR Saves More Lives
In a previous study carried out in Japan on 4000 cases in which victims of out of hospital cardiac arrest were resuscitated by people nearby either with uninterrupted chest compressions only or with rescue breathing. During the study, it was discovered that those victims who received chest compressions only from bystanders had 19.4% better results than those who received mouth to mouth ventilation, with an outcome of only 11.2%.
Everyone can learn chest compressions, but not everyone can do rescue breathing. This indicates the comfortability of the person performing CPR; the more the resuscitator delivers it, the greater the chances of survival and good neurologic outcome for the cardiac arrest patient.
Although the bystander CPR rate has increased in recent years, it is still alarmingly low. In addition, the American Heart Association's research suggests that people are often reluctant to initiate bystander Cardiopulmonary resuscitation because they fear an infection from mouth-to-mouth contact.
It is important to remember that CPR is a basic life support skill that anyone can perform, regardless of their training or experience. According to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, if you are not trained in giving mouth to mouth ventilation, you can still save a person's life by performing Cardiopulmonary resuscitation by chest compression. Knowing how to perform high-quality chest compressions can mean the difference in survival for someone experiencing out-of-hospital cardiac arrest.