CPR: A-B-C’s turn to C-A-B
Published 6:20 pm Saturday, October 30, 2010
The American Heart Association is rearranging the A-B-C’s of cardiopulmonary resuscitation, more commonly known as CPR.
The association is changing its former recommendation for the order of steps in the process. Formerly, the association had recommended that people remember the A-B-C acronym, which stood for Airway-Breathing-Compressions, and perform CPR steps in that order. Now, the organization is recommending that the steps should be changed to C-A-B (Compressions-Airway-Breathing).
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While Lisa Harrell of the Suffolk chapter of the American Red Cross said the Red Cross has yet to change any of its instructions until it further researches the science behind the changes, “The benefit of knowing how and when to do [CPR] is worth a life,” Harrell said. “If you’re able to help someone who has stopped breathing sustain oxygen rich blood, you can keep them from losing the ability to do many of the things they could do before that incident. We want to make Suffolk a safer place to live and visit. This is a way to do that.”
For more than 40 years, CPR instructions have been to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and then giving chest compressions.
According to the association, research shows that rescuers who started CPR with opening the airway took 30 critical seconds longer to begin chest compressions than rescuers who began CPR with chest compressions.
Because the old approach can cause delays in starting chest compressions, the association is recommending that rescuers should begin the process with chest compressions to ensure oxygen-rich blood is kept circulating throughout the body.
In previous guidelines, the association also recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally.
Victims of cardiac arrest will have oxygen remaining in their lungs and bloodstream for the first few minutes, so starting CPR with chest compressions can pump that blood to the victim’s brain and heart sooner.
The change in the CPR sequence applies to adults, children and infants, but excludes newborns.
Other recommendations, largely based on research published since the 2005 resuscitation guidelines, include:
4During CPR, rescuers should give chest compressions a little faster, at a rate of at least 100 times a minute.
4Rescuers should push deeper on the chest, compressing at least two inches in adults and children and 1.5 inches in infants.
4Between each compression, rescuers should avoid leaning on the chest to allow it to return to its starting position.
4Rescuers should avoid stopping chest compressions and avoid excessive ventilation.
4All 911 centers should assertively provide instructions over the telephone to get chest compressions started when cardiac arrest is suspected.
Since 2008, the American Heart Association has recommended that untrained bystanders use hands-only CPR — CPR without breathing — for an adult victim who suddenly collapses.
“We support hands-only technique for bystanders,” said Lisa Harrel of the Suffolk chapter of the American Red Cross. “But, we do feel that those working in healthcare or as a responder should be certified in full CPR and ready to practice it wherever they are.”
For hands-only CPR, call 911 and push hard and fast on the center of the chest until professional help or an AED arrives.