New CPR guidelines for lay responders

[Danielsperry]

From what I understand, lay responders are being taught to give CPR if there is no breathing and they are not taught to take a pulse. I know it's unlikely my heart would still be beating but if If it was... how would the chest compressions affect my heart rhythm and such? could it cause permanent damage?

Thanks

 

[DPM]

They might break a few ribs but it's not going to interrupt normal circulation to any significant degree if it even has an effect at all.

So you might get an increase in unnecessary CPR, but also in increase in early CPR in true cardiac arrest cases. The analysis shows that laypeople take too long to 'find' a pulse, aren't very good at it, nor do they trust themselves that there really isn't one.

 

[Danielsperry]

They might break a few ribs but it's not going to interrupt normal circulation to any significant degree if it even has an effect at all.

So you might get an increase in unnecessary CPR, but also in increase in early CPR in true cardiac arrest cases. The analysis shows that laypeople take too long to 'find' a pulse, aren't very good at it, nor do they trust themselves that there really isn't one.

That answers my question! Thanks so much!

 

[EMT John]

there is more to it then them just being taught to do hands only. its taught as an option in certain situations and minimal cardiac damage could be caused but nothing life threatening in done correct.

 

[DPM]

there is more to it then them just being taught to do hands only. its taught as an option in certain situations and minimal cardiac damage could be caused but nothing life threatening in done correct.

He doesn't mean hands only, the new layperson guidelines tell you not to look for a pulse. If there is no breathing after 10 seconds you start CPR.

The hands only stuff is for similar reasons. laypeople have been found to be apprehensive about rescue breathing (sticking their mouth on someone!), they gave too much emphasis on their effectiveness and interrupted chest compressions for too long, and were often ventilating inadequately. They felt that removing rescue breathing simplified things enough so that more people would attempt chest compressions, and they would be of a better quality and provided sooner.

 

[Simusid]

I know the OP is not asking about Hands Only CPR but check out these stats:

Rate of survival to hospital discharge
No CPR - 5.25%
conventional CPR - 7.8%
Hands Only - 13.3%

From 2005 to 2009 lay rescuer CPR increased from 28% to 40%
The proportion of CPR that was Hands Only increased from 20% to 76%.

Overall survival increased from 3.7% to 9.8%

Ref http://archinte.jamanetwork.com/article.aspx?volume=171&issue=1&page=87

So for the people that I cannot convince to take a formal class, I am still pestering them (a lot) with "call 911 and do good compressions until someone tells you to stop"

 

[AnthonyM83]

Had a coworker give a patient a pericardial tamponade from CPR once....it's definitely not harmless (or only insignificant injuries). But most laypeople probably aren't going to be as aggressive as EMS might be with compressions (as a generalization).

 

[Achilles]

[YOUTUBE]http://www.youtube.com/watch?v=A3b9gOtQoq4&feature=youtube_gdata_player[/YOUTUBE]

 

[Simusid]

I can't find the specific study that I read, this is the best ref that I can find right now http://emj.bmj.com/content/early/2011/10/19/emermed-2011-200187.abstract

Basically, they compared compressions given to a musical song (stayin alive, another one bites the dust, and the ones in this study) versus no music or a metronome. Apparently people do better compressions (adequate depth) with no music. I'm not only interested in the result but the fact that someone decided to study it!

 

[mycrofft]

Take a CPR course or become an instructor.
We were told that, overall, CPR performed upon a beating heart does not do the damage once thought.
I'm waiting for the dreaded Xyphoid Spearhead of Death to be demystified. I teach my students to avoid it, not because it will act like a Ginsu knife, but because nothing helpful will result from compressing that point.

 

[Danielsperry]

Edited until I figure how to delete accidental post - sorry

 

[Danielsperry]

Take a CPR course or become an instructor.
We were told that, overall, CPR performed upon a beating heart does not do the damage once thought.
I'm waiting for the dreaded Xyphoid Spearhead of Death to be demystified. I teach my students to avoid it, not because it will act like a Ginsu knife, but because nothing helpful will result from compressing that point.

I took ARC's CPR/AED for the Professional Rescuer yesterday. In that class we were taught to take a pulse for every victim. The instructor later told me that ARC's classes for basic CPR don't teach how to find the pulse... she had a look of concern on her face saying that too.

I definitly agree with the philosophy that when in doubt, a lay responder should perform CPR on a unconsious victim that is not breathing instead of over thinking the "what if's". But I am also interested in researching the difference of CPR on a beating heart vs. a non beating heart. What you said about the Xyphoid sound worthwhile to research... I'll be doing my homework

I really appriciate everyone's input on this.

 

[EMT John]

..I'm waiting for the dreaded Xyphoid Spearhead of Death to be demystified... .

Love it!