Hands only CPR

[paulears]

Has CPR done away with the breathing part? Vinny Jones on the ad says no mouth to mouth needed, just chest compressions. Is this the new FAW rule too? When I did mine, the mouth to mouth was optional?

[Aaron-Hill07]

Mouth to mouth has always been something your only supposed to do if you feel your up to it/know how to correctly..

 

But, yes... recently there has been a big emphasis on hands-only CPR. You'll find from now on, training courses, manuals, first aid guides etc will only advise hands-on as opposed to the combination of chest compressions and rescue breaths :)

[rossmck]

First Aid training still includes rescue breaths, but hands only is a lot better than nothing ... and most people don't do the rescue breaths effectively (and at the same time stop the hands on bit which is generally harder to get wrong)

 

Hands-only CPR should mean people that otherwise wouldn't do ANYTHING might do something that will help. Those of us who have been trained and know how to do the rescue breaths correctly should, so I've been told, continue to do so.

[Aaron-Hill07]

Ross, out of interest.. when did you do your most recent course? As you say, the reason they're advising against it is because most people don't know how to or at least don't know the correct ration between compressions to breaths!

[Brian]

... or at least don't know the correct ration between compressions to breaths!

But what is the correct ration? In the time since I did my first course several decades ago, the numbers have changed at least 5 times. It'd be nice if they made their mind up. After all, human anatomy hasn't changed much in the last century.

[Aaron-Hill07]

Well, that is certainly a valid point Brian.. SJA say its 30 chest compressions to 2 rescue breaths..

 

I'm pretty sure a year ago it was different.. and it's probably changed many times before then.. as you say, Anatomy hasn't particularly changed.. but there is an argument that the respiratory system has developed due to changes in the air around us, polution etc. Who know's who makes up the 'correct ratio's'.. I've been trained as a community first responder for 30 compressions to 2 rescue breaths but recently we've been told not to do rescue breaths unless 100 compressions fail...

 

Who knows!

[rossmck]

Ross, out of interest.. when did you do your most recent course? As you say, the reason they're advising against it is because most people don't know how to or at least don't know the correct ration between compressions to breaths!

 

Was 30 to 2 the last time... which was a couple of years ago now, keep meaning to redo it, haven't gotten around to it yet.

 

But yes, I'm sure it was something else before that - because I remember it changing (?)

[Gerry]

When I did my FAW, many years ago, it was 10 to 1, but if there were two of you, one doing compressions and one doing the breathing, it was 5 to 2.

Cheers

Gerry

[bigclive]

There is a bias towards just the compressions because the blood holds oxygen for a while after the victim stops breathing and it has been found that keeping that oxygenated blood flowing round the body is the most important part of first aid CPR. The speed has also increased.

 

More importantly, my recent BECTU training also included the use of a portable defibrillator which is the way ahead. These things are genuinely idiot proof these days and will ONLY attempt defibrillation if they detect a heart in the throes of death.

 

You can buy an AED (Automatic External Defibrillator) for about a grand these days, so theatres should really have them in their first aid kit.

[rossmck]

You can buy an AED (Automatic External Defibrillator) for about a grand these days, so theatres should really have them in their first aid kit.

 

The BHF provides grants for purchase of them too, I would imagine many theatres probably meet the requirements for them, but yes definitely worthwhile having (most shopping centres, major stations etc do now)

[charl.ie]

Human anatomy may not have changed, but the number of accident reports filed, along with new medical research does change things. I was told a while back that the reason it does change is because of data gathered from real-world incidents where CPR is used, which makes sense. It would be more stupid to keep the ineffective method than it is to change it every years.

 

Unless anyone is volunteering for a clinical trial?

[the kid]

+1 to above.

 

I have heard that the hands only is because someone got something like HIV from mouth to mouth.

 

As for ratios I cannot remember but from my trainer anything is better than nothing. BUT only when done correct, the number of issues they (he was a paramedic) get from wrong position of the head and thus all the work has done nothing.

 

I do remember we are meant to start with compression 1st as there is enough o2 in the blood and lungs already.

[scjb]

Let's face facts. Women are going to get mouth-to-mouth, men are going to have to make do with hands-only CPR!

[djw1981]

From a basic physiology point of view, the chest compressions do force air in and out of the lungs as well as compressing the hear, thus forcing blood around the body somewhat.

 

Surveys showed that people didn't want to administer the rescue breaths to strangers, and thus didn't attempt any CPR. Obviously, compressions alone are better than nothing, and with the removal of the rescue breaths, no debate regarding 15:2, 15:1, 10:1, 5:2 etc, the only issue was to rind a song tuning at approx 100 compressions per minute.

 

Most Office blocks, shopping centres etc will be fitting AED's with security staff trained in how to use them - though instructions are fairly idiot proof. They are also in use in hospitals -with secuity and cleaning staff trained to use them so that life support can be implemented even whilst a cardiac arrest team is on their way. The hospital models do have over-rides for medical/nursing staff to use if they feel that the machine had made a mis-diagnosis of the heart rhythm.

 

The Uk has reduced heart attack deaths by almost a half in the past 25 years, partly thanks to the ubiquity of CPR in first aid courses; partly due to improved prevention, secondary prevention and treatment options.

 

Spot who has been on his ALS course at 'day job' in the past month

[matt_h]

Having done my refresher FAW last week:

 

CPR breath to compression ratio remains at 30 compressions to 2 rescue breaths (which is the same as it was 3 years ago). Those who have been trained to give rescue breaths should continue to do so.

 

According to our trainer the BHF has conducted studies showing that those who received some form of CPR stood a 40% better chance of surviving than those who didn't. For exactly the reason that bigclive states above, it is extremely unlikely that CPR alone will revive somebody (the best chance is with a defibrilator,and dialling 999 before you do anything else exponentially improves your casulty's chanes! ;) ), it will however keep oxygenated blood flowing to the vital organs, and carry away some of the CO2. Those who haven't been trained to give rescue breaths(and often those who have) rarely open the airway properly/fully, so little extra oxygen is received by the casulty.

 

 

Perhaps the biggest change this time around is to ABC (Airway, Breathing, Circulation), which has been reduced to just B, if they aren't breathing then you can assume that the heart has also stopped!

 

Edit: Damn, beaten by the medic!