Dallas – “Push hard, push fast” next time you give CPR to someone having cardiac arrest, say new, simpler guidelines in a radical departure from past advice.
Putting the emphasis on chest compressions instead of mouth- to-mouth resuscitation, the American Heart Association now urges people to give 30 compressions – instead of 15 – for every two rescue breaths.
“Basically, the more times someone pushes on the chest, the better off the patient is,” said Dr. Michael Sayre, an Ohio State University emergency medicine professor who helped develop the guidelines announced Monday.
“We have made things simpler,” he said. “Push hard on the person’s chest and push fast.”
The streamlined guidelines should make it easier for people to learn CPR. Earlier rules were different for adults and for children and called on untrained rescuers to stop pushing the chest periodically to check for signs of circulation.
Now, the advice is the same for all ages – 30 compressions – and you don’t have to stop to check for improvement. What’s important is to keep the blood flowing.
Studies have shown that blood circulation increases with each chest compression, and it must be built back up after an interruption.
Sudden cardiac arrest – when the heart suddenly stops beating – can occur after a heart attack or as a result of electrical shock or near-drowning. It’s most often caused by an abnormal heart rhythm.
A person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing.
More than 300,000 Americans die from it each year. About 75 percent to 80 percent of all cardiac arrests outside a hospital happen at home, and effective CPR can double chances of survival.
“The most common reason many people die from cardiac arrest is no one nearby knows CPR,” Sayre said. “For the bystander that witnesses a collapse, the main danger is inaction.”
More than nine out of 10 cardiac arrest victims die before they get to the hospital, the heart association estimates.
The new guidelines call for 911 operators to be trained to provide easy-to-follow CPR instructions by phone.
The heart association also offers new guidance to professionals, calling for cooling down cardiac arrest patients to about 90 degrees Fahrenheit for 12 to 24 hours. Two significant studies have shown that practice can improve survival and brain function for those who are comatose after initial resuscitation.
There are a variety of methods – both internal and external – for cooling a person down, but the guidelines don’t recommend a specific approach.
The guidelines also advise just one shock from a defibrillator before beginning chest compressions instead of giving up to three shocks first. Studies show that the first shock works more than 85 percent of the time.
Defibrillators have been popping up in public places like airports and businesses, but the heart association says that more public places need to install the devices.
Survival rates have been as high as 49 percent to 74 percent for lay rescuer programs when defibrillators are placed in casinos or airports or used by police.
