NationStates Jolt Archive


Chest cempressions alone may be better

Sel Appa
16-03-2007, 18:23
A study in Japan found that concentrating on chest compressions and not worrying as much abut the breaths may be better. This may have more lives because people are scared of mouth-to-mouth. This is very interesting because we just did CPR in Health. I hate these procedures and stuff and all the steps. As long as you start doing the compressions and call 911, you shouldnt try to remember every step. :headbang:

Link (http://news.yahoo.com/s/ap/20070316/ap_on_he_me/cpr_advice)

Chest compression — not mouth-to-mouth resuscitation — seems to be the key in helping someone recover from cardiac arrest, according to new research that further bolsters advice from heart experts.

A study in Japan showed that people were more likely to recover without brain damage if rescuers focused on chest compressions rather than rescue breaths, and some experts advised dropping the mouth-to-mouth part of CPR altogether. The study was published in Friday's issue of the medical journal The Lancet.

More than a year ago, the
American Heart Association revised CPR guidelines to put more emphasis on chest presses, urging 30 instead of 15 for every two breaths given. Stopping chest compressions to blow air into the lungs of someone who is unresponsive detracts from the more important task of keeping blood moving to provide oxygen and nourishment to the brain and heart.

Another big advantage to dropping the rescue breaths: It could make bystanders more willing to provide CPR in the first place. Many are unwilling to do the mouth-to-mouth part and become flummoxed and fearful of getting the ratio right in an emergency.

Sudden cardiac arrest — when the heart suddenly stops beating — can occur after a heart attack or as a result of electrocution or near-drowning. It's most often caused by an abnormal heart rhythm. The person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing.

In the new study, researchers led by Dr Ken Nagao of Surugadai Nihon University Hospital in Tokyo analyzed 4,068 adult patients who had cardiac arrest witnessed by bystanders. Of those, 439 received chest compressions only from bystanders, and 712 received conventional CPR — compressions and breaths.

Any CPR attempt improved survival odds. However, 22 percent of those who received just chest compressions survived with good neurological function compared with only 10 percent of those who received combination CPR.

"Eliminating the need for mouth-to-mouth ventilation will dramatically increase the occurrence of bystander-initiated resuscitation efforts and will increase survival," Dr. Gordon Ewy, a cardiologist at the University of Arizona College of Medicine in Tucson, writes in an accompanying editorial.

A big caveat: The combination CPR in the Japanese study was given according to the old guidelines of 15 presses for every two breaths, not the 30 presses recommended now.

The American Heart Association said the study supports a focus on chest presses, but the association does not expect its advice to change. It recommends that bystanders provide compression-only CPR if they are "unwilling or unable" to do mouth-to-mouth breathing at the same time and for emergency dispatchers to give instructions on that.

The association wants to see survival results from programs that use compression-only CPR for cardiac arrest.

"It is important to note that victims of cardiac arrest from non-cardiac causes, like near-drowning or electrocution, and almost all victims of pediatric cardiac arrest benefit from a combination of rescue breathing and chest compressions," a heart association statement says.

More than 300,000 Americans die from cardiac arrest each year. About 75 percent to 80 percent of all cardiac arrests outside a hospital happen at home, and effective CPR can double a victim's chance of survival.

Roughly 9 out of 10 cardiac arrest victims die before they get to the hospital — partly because they don't get CPR.
Eve Online
16-03-2007, 18:24
They've found that defibrillation, even if done by someone untrained, saves far more lives than any form of CPR.

That's why they have started putting public defib machines in offices and malls and other public places.
Neesika
16-03-2007, 18:25
A study in Japan found that concentrating on chest compressions and not worrying as much abut the breaths may be better. This may have more lives because people are scared of mouth-to-mouth. This is very interesting because we just did CPR in Health. I hate these procedures and stuff and all the steps. As long as you start doing the compressions and call 911, you shouldnt try to remember every step. :headbang:

Link (http://news.yahoo.com/s/ap/20070316/ap_on_he_me/cpr_advice)

Scared of mouth-to-mouth? Huh? Okay, perhaps I could understand that. I watched a special on this study last night, and they mentioned that chest compressions are most effective during pure cardiac arrest, because the blood still has enough oxygen to keep the brain alive for a while, and stopping the compressions to give air actually just decreases the effectiveness of the compressions themselves. Still, not sure that people are necessarily going to be more willing to jump in...

And they also were careful to point out that you should still do mouth-to-mouth in drownings, and other appropriate situations that are not pure cardiac arrest.
The Potato Factory
16-03-2007, 18:25
They've found that defibrillation, even if done by someone untrained, saves far more lives than any form of CPR.

That's why they have started putting public defib machines in offices and malls and other public places.

Maybe everyone should just wear Tesla gloves and rubber boots.
Neesika
16-03-2007, 18:26
They've found that defibrillation, even if done by someone untrained, saves far more lives than any form of CPR.

That's why they have started putting public defib machines in offices and malls and other public places.

Great....forget pulling the fire alarms for shits and giggles now...let's use the defibrillator on a random stranger!:eek:
Snafturi
16-03-2007, 18:26
CPR is constantly changing. I have to get certified once a year and it's amazing how fast it changes.
Sel Appa
16-03-2007, 18:28
They've found that defibrillation, even if done by someone untrained, saves far more lives than any form of CPR.

That's why they have started putting public defib machines in offices and malls and other public places.

Well the thing tells you what to do. Also, anything is better than nothing. Who carries an "AED" with them...?
Szanth
16-03-2007, 18:33
Maybe everyone should just wear Tesla gloves and rubber boots.

That'd be fucking awesome. People going around trying to shock eachother all the time.
Isidoor
16-03-2007, 18:34
how many steps did you have to remember? because we get CPR in med-school. and for non-professionals it are only about 10 steps, wich are quite logical.

once you've done the essentials like making sure everybody is safe and called 911 then you only have to remember to do 30 compressions and 2 mouth-to-mouth's.

i sucked in CPR though. it's much harder than it looks when you're under stress and not really a veteran.
Eve Online
16-03-2007, 18:38
Great....forget pulling the fire alarms for shits and giggles now...let's use the defibrillator on a random stranger!:eek:

I sit about 10 meters from the nearest one. They're all over the place in our building.
Smunkeeville
16-03-2007, 18:38
Scared of mouth-to-mouth? Huh?
I have a thingy in my purse so that when I give mouth to mouth if they come to and start breathing that they won't puke in my mouth ;) cool yeah?
Isidoor
16-03-2007, 18:40
I have a thingy in my purse so that when I give mouth to mouth if they come to and start breathing that they won't puke in my mouth ;) cool yeah?

do you have other gadgets like that too? i can't imagine that you use that a lot so you might have other cool stuff that you don't use a lot in there too.
Snafturi
16-03-2007, 18:42
I have a thingy in my purse so that when I give mouth to mouth if they come to and start breathing that they won't puke in my mouth ;) cool yeah?

I have one too. I'd never give mouth to mouth to an adult I didn't know without one. Too many diseases out there.
Sel Appa
16-03-2007, 18:44
how many steps did you have to remember? because we get CPR in med-school. and for non-professionals it are only about 10 steps, wich are quite logical.

once you've done the essentials like making sure everybody is safe and called 911 then you only have to remember to do 30 compressions and 2 mouth-to-mouth's.

i sucked in CPR though. it's much harder than it looks when you're under stress and not really a veteran.

In an emergency you aren't going to remember half of it. The steps are fine, it's just there's too much emphasis on some of them and getting the exct number.


Maybe one person could give breaths and another compresses?
Sel Appa
16-03-2007, 18:45
Great....forget pulling the fire alarms for shits and giggles now...let's use the defibrillator on a random stranger!:eek:

I believe most set off an alarm when the case is opened.
Isidoor
16-03-2007, 18:47
In an emergency you aren't going to remember half of it. The steps are fine, it's just there's too much emphasis on some of them and getting the exct number.


Maybe one person could give breaths and another compresses?

-what kind of steps did you have to do? we only had to:
-make sure everyone is safe
-ask if the person lying on the floor is ok
-call for help
-do a head-tilt-chin-lift and clear their throat
-check if (s)he breaths
-call 911 and say your name, location, that your victim doesn't breath anymore and that you're starting CPR
-30 compressions
-2 breaths
-repeat until the emergency services arrive.

(i believe it's like that, maybe i forgot a step)


and you can do CPR with two persons. one does the compressions and when he's ready the other can do the breaths. when one is tired (wich happens faster than you think) you can switch.
Szanth
16-03-2007, 18:50
I believe most set off an alarm when the case is opened.

I believe Old Greg's got a mangina.
Smunkeeville
16-03-2007, 19:09
do you have other gadgets like that too? i can't imagine that you use that a lot so you might have other cool stuff that you don't use a lot in there too.
I have a lot of stuff in my purse.....I might start a thread about it later.

I have one too. I'd never give mouth to mouth to an adult I didn't know without one. Too many diseases out there.

yeah, and I never know what they have been eating so I could get sick... not that I wouldn't risk it if someone really needed my help, but it's nice to have such a groovy device.
Szanth
16-03-2007, 19:16
I have a lot of stuff in my purse.....I might start a thread about it later.



yeah, and I never know what they have been eating so I could get sick... not that I wouldn't risk it if someone really needed my help, but it's nice to have such a groovy device.

Women and their purses of endless doohickeys. :D
The Treacle Mine Road
16-03-2007, 19:17
Unfortunately it is illegal to carry around amyl nitrate, which is a powerful vasodilator and could be used to save someone having a heart attack. Otherwise the chance of recovery from most heart troubles without being in a hospital is very slim. CPR and defibbrillators help though
Sel Appa
16-03-2007, 20:00
-what kind of steps did you have to do? we only had to:
-make sure everyone is safe
-ask if the person lying on the floor is ok
-call for help
-do a head-tilt-chin-lift and clear their throat
-check if (s)he breaths
-call 911 and say your name, location, that your victim doesn't breath anymore and that you're starting CPR
-30 compressions
-2 breaths
-repeat until the emergency services arrive.

(i believe it's like that, maybe i forgot a step)


and you can do CPR with two persons. one does the compressions and when he's ready the other can do the breaths. when one is tired (wich happens faster than you think) you can switch.

BUt who can remember that when the time comes? And it's more important to start the procedure and call or have called 911 or whatever.

Unfortunately it is illegal to carry around amyl nitrate, which is a powerful vasodilator and could be used to save someone having a heart attack. Otherwise the chance of recovery from most heart troubles without being in a hospital is very slim. CPR and defibbrillators help though

Perhapse you mean nitrite?
Whereyouthinkyougoing
16-03-2007, 20:06
Unfortunately it is illegal to carry around amyl nitrate, which is a powerful vasodilator and could be used to save someone having a heart attack. Otherwise the chance of recovery from most heart troubles without being in a hospital is very slim. CPR and defibbrillators help thoughPoppers? I don't think I was aware that poppers were illegal. Live and learn.

Edit: Checking wiki tells me that it varies from country to country. Duh. *slaps forehead*
Isidoor
16-03-2007, 20:31
Unfortunately it is illegal to carry around amyl nitrate, which is a powerful vasodilator and could be used to save someone having a heart attack. Otherwise the chance of recovery from most heart troubles without being in a hospital is very slim. CPR and defibbrillators help though

you could always use dynamite (http://en.wikipedia.org/wiki/Nitroglycerin#Medical_use)instead
Sarkhaan
16-03-2007, 21:05
They've found that defibrillation, even if done by someone untrained, saves far more lives than any form of CPR.

That's why they have started putting public defib machines in offices and malls and other public places.defib is only helpful in two heart beat patterns...otherwise, CPR is still needed

In an emergency you aren't going to remember half of it. The steps are fine, it's just there's too much emphasis on some of them and getting the exct number.


Maybe one person could give breaths and another compresses?
2 person CPR, not at all uncommon

BUt who can remember that when the time comes? And it's more important to start the procedure and call or have called 911 or whatever.
Actually, you can do more harm by just starting chest compressions on someone who doesn't need it.
Lets go through the steps, shall we?
survey the scene:
well, that seems logical...if they are in a dangerous location, don't risk your own life
Check if they're okay....well, if they're awake, there might be nothing wrong
ABC's...Airway, breathing, circulation...if they're choking, you don't do CPR. If the airway is blocked, you can't. breathing, you don't need CPR. circulation, you don't need compressions.
call 911...CPR won't keep them alive.
begin CPR in ratio...well, yeah. Ratio is important to a large extent depending on what the situation is.


so...which step are you going to drop?


btw, I'm CPR for the professional rescuer, AED, and lifeguard certified.
Isidoor
16-03-2007, 21:07
ABC's...Airway, breathing, circulation...if they're choking, you don't do CPR. If the airway is blocked, you can't. breathing, you don't need CPR. circulation, you don't need compressions.

just curious, but what if somebody chokes on a piece of food for instance?
first you have to tell him to cough, then you have to hit him on the back for 5 times than you have to perform the Heimlich manoevre (sp?). but after that, doen't you have to do CPR?
Sel Appa
16-03-2007, 21:15
defib is only helpful in two heart beat patterns...otherwise, CPR is still needed


2 person CPR, not at all uncommon

Actually, you can do more harm by just starting chest compressions on someone who doesn't need it.
Lets go through the steps, shall we?
survey the scene:
well, that seems logical...if they are in a dangerous location, don't risk your own life
Check if they're okay....well, if they're awake, there might be nothing wrong
ABC's...Airway, breathing, circulation...if they're choking, you don't do CPR. If the airway is blocked, you can't. breathing, you don't need CPR. circulation, you don't need compressions.
call 911...CPR won't keep them alive.
begin CPR in ratio...well, yeah. Ratio is important to a large extent depending on what the situation is.


so...which step are you going to drop?


btw, I'm CPR for the professional rescuer, AED, and lifeguard certified.

Still, they drill this rubbish into your head and you forget it anyway. Most of it is common sense and if you don't have that, oh well.
Sarkhaan
16-03-2007, 21:28
just curious, but what if somebody chokes on a piece of food for instance?
first you have to tell him to cough, then you have to hit him on the back for 5 times than you have to perform the Heimlich manoevre (sp?). but after that, doen't you have to do CPR?

What I know is a bit different from standard CPR because mine is professional rescuer. I think it is basically the same

Encourage them to cough it up. If they can't, ask if they want help. If yes, give them heimlich. Continue doing this untill either they cough it up or go unconscious. If they say no, wait untill they go unconscious and assume concent. (I think this is different from standard CPR) Stradle victim facing their head. Do 5 abdominal thrusts. Check mouth for debris. Check ABC's. If the airway is clear, but no breathing or circulation, move to CPR. If clear with circulation, but no breathing, move to rescue breathing. If clear and breathing with circulation, place in rescue position. If it isn't clear, do 5 more abdominal thrusts. Repeat untill either the airway is clear or untill help arrives

you can only do CPR once the airway is clear (if they can't pull air in or out, you won't be able to either). If they were conscious when it came out, no need for CPR. If they were unconscious, you move to CPR (or other needed steps)
Sarkhaan
16-03-2007, 21:31
Still, they drill this rubbish into your head and you forget it anyway. Most of it is common sense and if you don't have that, oh well.

If it is needed, then it isn't rubbish. Which step can you drop? Are you going to give CPR when they are breathing? Congrats, you just broke someones ribs for no reason, and possibly caused more injurys.

They teach you the proper steps and order for a reason. It doesn't make sense to call 911 before you check the victim and know what is wrong. It doesn't make sense to survey the scene after you've started CPR.
German Nightmare
16-03-2007, 21:33
I've learned CPR, either with mouth-to-nose or mouth-to-mouth, when I was working as a paramedic.
Also, I learned CPR alone, and as a team, where one gives breath and the other one pumps.

Can't really say I'm too fond of the "let's forget about the oxygen". That's as stupid as only giving breath and not distributing it in the body...

3 weeks without food,
3 days without water,
3 minutes without oxygen.

The new development of installing defis in public buildings is good, though. Even an untrained person can't do anything wrong because the computer will make the call on when and how to shock once the paddle-stickers are applied correctly (and how hard can that be if you follow the instructions?).

One development that came up very recently and goes through a testing phase over here right now are instant cooling packages that you put on the body to cool it down from 37°C to about 32°C.
It raises chances of surviving a heart attack dramatically, and a nice side-effect is brain-damage to occur less-likely, too. Pretty much the same principle is at work as if a person has broken into the ice and its body temperature drops a lot.

Anyway, I can only ask everyone to go take a course on CPR if you haven't already done so, or take a refreshment-course if it's been some time.

Saving lives feels really good (even if it doesn't always work, it's always good to give it a least a try!).

Besides, there is a good reason why in CPR, you are to check for pulse and breathing in a regular timeframe!
Ifreann
16-03-2007, 21:36
I learned CPR ages ago in scouts, and I only vaguely remember it. I do remember RessuciJimmy(sp?), the doll we had to practice CPR on. He was anatomically semi-correct :eek:
Smunkeeville
16-03-2007, 21:39
I learned CPR ages ago in scouts, and I only vaguely remember it. I do remember RessuciJimmy(sp?), the doll we had to practice CPR on. He was anatomically semi-correct :eek:

we had RescueAnnie when I learned adult CPR, and we had to ask "Annie are you okay?, are you okay Annie?" and I had to work hard not to sing it LOL

when I learned infant CPR the dummy didn't have a name :( of course you don't ask a baby if they are okay though, so I guess it didn't need one.
Damaske
16-03-2007, 21:41
Still, they drill this rubbish into your head and you forget it anyway. Most of it is common sense and if you don't have that, oh well.

No its NOT common sense. Would you know where to put your hands during chest compressions? Would you know that even if a person is not breathing it doesn't mean you automatically start CPR? (because alot of people DO think "he's not breathing! start CPR!") You are tought what to do and what not to do in classes. Because if you rely on "common sense" you could do more harm than good.
Sarkhaan
16-03-2007, 21:46
I've learned CPR, either with mouth-to-nose or mouth-to-mouth, when I was working as a paramedic.
Also, I learned CPR alone, and as a team, where one gives breath and the other one pumps.

Can't really say I'm too fond of the "let's forget about the oxygen". That's as stupid as only giving breath and not distributing it in the body...From what I've read, they only suggest that for pure cardiac arrest...not something like near-drowning...of course, that's just going to confuse people, and I doubt the AHA or Red Cross to integrate it.

One development that came up very recently and goes through a testing phase over here right now are instant cooling packages that you put on the body to cool it down from 37°C to about 32°C.
It raises chances of surviving a heart attack dramatically, and a nice side-effect is brain-damage to occur less-likely, too. Pretty much the same principle is at work as if a person has broken into the ice and its body temperature drops a lot.

ohhh....I haven't heard about those...sound fun.
Sarkhaan
16-03-2007, 21:48
we had RescueAnnie when I learned adult CPR, and we had to ask "Annie are you okay?, are you okay Annie?" and I had to work hard not to sing it LOL

when I learned infant CPR the dummy didn't have a name :( of course you don't ask a baby if they are okay though, so I guess it didn't need one.

haha...I did that too.

And we named the infant "Mortimer"
German Nightmare
16-03-2007, 21:49
From what I've read, they only suggest that for pure cardiac arrest...not something like near-drowning...of course, that's just going to confuse people, and I doubt the AHA or Red Cross to integrate it.
The way I learned it at the German Red Cross (as a conchie) is that you check for pulse and breathing, and usually do whatever the "patient" is lacking.
Suffocation, no breathing (sorry, that song just popped up) but a beating heart does not require the pumping - then again, without the breathing part, the heart will stop beating soon enough.
And when you have a complete cardiac arrest, they usually ain't breathing either.
ohhh....I haven't heard about those...sound fun.
I saw a documentary about it about 2 weeks ago. Looks like they're going to put them aboard the ambulances if they prove useful.
Pretty much like those chemical cooling packs for minor injuries, only much larger.
Ifreann
16-03-2007, 21:51
we had RescueAnnie when I learned adult CPR, and we had to ask "Annie are you okay?, are you okay Annie?" and I had to work hard not to sing it LOL

when I learned infant CPR the dummy didn't have a name :( of course you don't ask a baby if they are okay though, so I guess it didn't need one.

You've been hit by, you've be hit

A smooth criminal.
*grabs own crotch*
Smunkeeville
16-03-2007, 21:53
You've been hit by, you've be hit

A smooth criminal.
*grabs own crotch*

:D
Sarkhaan
16-03-2007, 21:59
The way I learned it at the German Red Cross (as a conchie) is that you check for pulse and breathing, and usually do whatever the "patient" is lacking.
Suffocation, no breathing (sorry, that song just popped up) but a beating heart does not require the pumping - then again, without the breathing part, the heart will stop beating soon enough.
And when you have a complete cardiac arrest, they usually ain't breathing either.
same thing here
I saw a documentary about it about 2 weeks ago. Looks like they're going to put them aboard the ambulances if they prove useful.
Pretty much like those chemical cooling packs for minor injuries, only much larger.ahh...that'd definatly be a good idea.

I might actually go for my EMT training sometime soon...I might need another good paying job to suppliment teaching early on.
German Nightmare
16-03-2007, 22:39
I might actually go for my EMT training sometime soon...I might need another good paying job to suppliment teaching early on.
How come that as important a profession as teaching gets so little pay? [This coming from an ex-paramedic going-to-be-teacher ;)]
Sarkhaan
16-03-2007, 23:32
How come that as important a profession as teaching gets so little pay? [This coming from an ex-paramedic going-to-be-teacher ;)]

no clue. I have waterfront lifeguard cert, and could easily pick up water park cert for summer jobs, and have bar tending cert...I just think EMT would pay better than the lifeguard, be a little more exciting, and would work well with bar tending.
German Nightmare
17-03-2007, 11:43
no clue. I have waterfront lifeguard cert, and could easily pick up water park cert for summer jobs, and have bar tending cert...I just think EMT would pay better than the lifeguard, be a little more exciting, and would work well with bar tending.
I think it would! First, you fill'em up, and then you save'em! :D

And driving an ambulance http://i6.photobucket.com/albums/y223/GermanNightmare/ambulance1252.jpg in traffic with lights and siren on is fun, albeit a piece of work. ;)