The American Heart Association unveiled dramatic changes Monday to its emergency cardiovascular care guidelines to make CPR simpler and less intimidating to a passerby thrust into the role of rescuer.
The revised guidelines for cardiopulmonary resuscitation shift the emphasis from mouth-to-mouth to chest compressions.
After reviewing thousands of studies, an international team of scientists found that CPR is too complicated for the average person. That is deadly for the more than 250,000 people who collapse each year in cardiac arrest.
“The most common reason many people die is because no one nearby knew CPR, or if they did know it, they didn’t actually do it,” says Michael Sayre of Ohio State University in Columbus, one of the authors of the new guidelines.
Now it’s simple: Call for help. Push the chest. Don’t stop.
Two rescue breaths can be given after every 30 compressions, but mouth-to-mouth is optional.
“Some CPR is better than no CPR,” says Robert O’Connor of Christiana Care Health System in Newark, another guideline author. Until emergency medical responders arrive, chest compressions alone can often be just as effective in saving a life, he says.
Historically, the heart association has emphasized the need for CPR certification and recertification. Now, when somebody collapses, does not respond to shaking and is not breathing, the authors hope that the closest person will simply start compressing the chest.
“The more times a person pushes on the chest, the better off the patient is, because there is more blood flow to the brain and other vital organs,” Sayre says.
The new guidelines are published in the journal Circulation. The authors say cities also must deploy more automated external defibrillators in public places and teach 911 dispatchers to give simplified CPR instructions.
But passersby who do CPR will buy precious minutes before a defibrillator or medic arrives. “If you have bystanders ready and willing to act and trained to respond, then you are going to be able to help improve survival,” says guideline co-author Mary Fran Hazinkski of Vanderbilt University Medical Center in Nashville.
The authors also called for emergency systems to measure their performance. In a 2003 investigation, USA TODAY found that cities most effective in saving victims of cardiac arrest keep track of their EMS performance. Some cities save 10 times more victims than others.