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Breath not an option, use hands on CPR

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When conducting onboard training classes, crew often say “we heard that you don’t breathe during CPR anymore.” I explain that this is half true but also half false.


Hands-only CPR is effective in many situations and easy to learn. It takes away the fear of doing mouth-to-mouth, which often stopped people from giving CPR at all.


For those who are trained and carry a CPR mask or barrier device, traditional CPR with 30 compressions followed by two breaths is still recommended. But who can put their hands on their CPR mask in an emergency? We do not always have the right Personal Protective Equipment with us when we need it.


But we do have two hands and we can help someone in cardiac arrest by performing hands-only CPR with good quality compressions. Hands-only CPR is where the rescuer rapidly pushes in the center of an unresponsive, non-breathing person’s chest. These chest compressions should be at least 2 inches deep on an adult at a pace of at least 100 times per minute.


Because this process is much easier to learn and remember, research shows bystanders are more likely to help, especially since they do not have to perform mouth-to-mouth.


“Anyone can do hands-only CPR and anyone can save a life,” contends Dr. Bentley J. Bobrow, medical director of the Arizona Department of Health Services’ Bureau of Emergency Medical Services and Trauma who lead a study on the effectiveness of hands-only CPR.


It is important to note that this applies to adults; infants and children should still receive the traditional 30:2 CPR with rescue breathing. The same applies to people who were choking, drowning or had trouble breathing before becoming unconscious.


Arizona studied 4,415 adults between 2005-2009 who experienced out-of-hospital cardiac arrest and were not treated by a medical professional. Of those, 2,900 received no CPR, 666 (about 15 percent) received traditional CPR and 849 (about 19 percent) received hands-only CPR.


About 13.3 percent of those who received hands-only CPR survived and were discharged from the hospital compared to only 7.8 percent of those who received traditional CPR, a 60 percent difference. Those who received no CPR at all fared the worst; only 5.2 percent lived.


Another fear with CPR is of hurting someone. When teaching classes, I always tell students if you think the victim is dead, start CPR. Adults who suddenly collapse and are not responsive are likely to be experiencing sudden cardiac arrest. This person’s chance of survival is almost zero unless you help. First call 911 or radio for help, then start pushing hard, fast and deep in the center of the victim’s chest. Try not to miss a beat, and after a minute or 2, switch with someone else. Continue compressions until help arrives or the patient begins to breath on his own.


A 2004 review of scientific literature showed that CPR compressions can cause fractures of ribs and/or the breastbone (sternum) about 30 percent of the time. It was also noted that these fractures did not cause any serious internal bleeding or serious damage. This is especially important when you consider the chance of surviving an out-of-hospital cardiac arrest is almost zero for a victim who does not immediately receive any CPR at all.


Hands-only CPR is effective because the lungs and blood contain enough oxygen to keep the brain and other vital organs alive for a few minutes, as long as someone is there to perform chest compressions. Allowing the chest to recoil and expand back to its normal position after each compression may also bring oxygen into the lungs.


Although hands-only CPR is designed to encourage bystanders to jump in and do their best, yacht captains and crew — people who earn their living working in and around the water — should take a recertification class at least once every two years and make certain they have an AED (Automated External Defibrillator) onboard as well as functioning pocket masks or other mouth barrier devices. They should also conduct regular preparedness drills to ensure that all crew are ready to act in the event of a medical emergency.


A few short videos that teach hands-only CPR.

http://www.youtube.com/watch?v=n5hP4DIBCEE

http://www.youtube.com/watch?v=ILxjxfB4zNk

 

Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or www.TheCPRSchool.com. Comments on this column are welcome at editorial@the-triton.com.


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