Thursday, October 26, 2006

New CPR Guidelines - Push Hard and Fast

If done effectively, cardiopulmonary resuscitation (CPR) can double the survival rate from sudden cardiac death. 75% of all out-of-hospital cardiac arrests happen at home, so being able to perform CPR can make the difference between life and death for a loved one.

The basic CPR algorithm is the same. However, the new recommendations advise that instead of the old 15:2 ratio of compressions-to-breaths, rescuers should now use a 30:2 ratio for all victims except newborns. There should be 100 compressions per minute.

The two breaths should be given over a period of one second each and should produce a visible chest rise. Compressions should not be interrupted for more than 10 seconds.

If there are 2 rescuers present, then it is advised to alternate every 2 minutes or every 2 cycles of compression.

Remember that prior to starting CPR, it is advised to call 911 and to get an AED (automated external defibrillator) if easily available. A rapid response is crucial as brain death starts to occur about 5 minutes after cardiac arrest if CPR and defibrillation are not provided. The chance of survival in general falls about 10% for every minute of delay in CPR.

Summary of major guideline differences :
Compression:Ventilation ratio – Adult,with unprotected airway(compression rate 100/min)
New 2005 guideline: 30:2
Old 2000 guideline: 15:2

Ventilation rate (with protected airway)
New: Max 8–10 per minute
Old: 10–12 per minute

Duration of CPR between shocks
New: 2 minutes
Old: 1 minute

Pulse check post-shock
New: No. Resume CPR immediately post-shock.
Old: Yes

Shocks per defibrillation attempt
New: Single shock, preferably biphasic
Old: 3 escalating energy "stacked" shocks


Post cardiac arrest care
New: Cool unconscious adult patients with spontaneous circulation to 32–34°C for 12–24 hr
Old: No recommendations

American Heart Association site will help you find classes near you.


References: Canadian Journal of Emergency Medicine. Circulation 2005.
American Heart Association.
Photo: courtesy of first-aid-cpr.

12 comments:

Bill Mayweather said...

Very Interetsing Post! Well done.

Mike said...

I know CPR is a medical term and it's called Cardiopulmonary resuscitation .
But what is it exactly? how it helps the patient?

Dr. Taraneh Razavi said...

When you breathe for someone you are supplying the oxygen, and when you compress the chest you are pumping their heart for them so that blood can circulate in the body and tranasport that oxygen. With out the oxygen and the blood circulating, the tissues will start to die.

Mike said...

Thank you dr. taraneh razavi, well done. Now I understand the term.

Guy Barry said...

I think its great there is much info about about cpr
?

AEDhub99 said...

I recently published an article on AEDs – here is a quote from it, in case you are interested:

Statistics give us more and more pieces of information that are bound to worry us, to make us react and change something if we can. More and more people and in earlier and earlier stages of their life die of a heart disease. Statistics, only in the US, are extremely alarming:
- Every 30 seconds someone dies because of a heart disease;
- More than 2.500 Americans die daily because of heart diseases;
- Every 20 seconds there is a person dying from a heart attack;
- Each year 6 million people are hospitalized because of a heart disease;
- The number 1 killer is a heart disease.
Although AEDs are not a universal panacea for all heart diseases, nothing else can compete to its major feature, that of actually re-starting the heart after it has been stopped by a sudden cardiac arrest. Under these circumstances is it necessary to ask you why anyone in this world, any family, in any home would hope for having such a device in their first aid locker?

If you feel this helps, please drop by my website for additional information, such as Public Access Defibrillation PAD or additional resources on AED manufacturers such as Philips defibrillators, Zoll AEDs or Cardiac Science AEDs.

Regards,

Michael

Anthony said...

Excellent Post -

I would like to introduce myself, I am Anthony Curci and I am the CEO of a start-up which has developed a very interesting and useful, voice prompt, emergency informational product called SafetyMate.

SafetyMate is a unique and award winning product, focused on providing critical emergency information to a lay person during the first moments of a medical emergency.

SafetyMate is a portable, interactive, bilingual (English/Spanish) device that delivers audible, interactive, instructions for a number of common medical emergencies.

SafetyMate fills the gap in time between the onset of a medical emergency and the time that professional help actually arrives to the victim. (This can range from only minutes, to hours depending on the location).

SafetyMate is designed for use in actual emergencies, but can also be of value during First-Aid and CPR training, and supporting the on-going refreshing of this critical training information.

SafetyMate provides information about what you SHOULD and SHOULD NOT do in specific emergencies, thereby providing a consistent "standard of care", protecting involved parties from taking the wrong, or inappropriate actions. In this way, SafetyMate protects no only the victim, but also assists nurses, administrators, employers, employees, family, and friends from either taking the wrong or inappropriate actions in such emergencies.

SafetyMate incorporates the latest 2005 ECC guidelines for CPR / First-aid emergencies. It is also an excellent companion product to those locations where AED's are deployed, addressing many other situations beyond just Sudden Cardiac Arrest.

SafetyMate is being deployed in a wide range of applications, including homes, schools, on school buses, at health/fitness clubs, office environments, child-care facilities, assisted living and care facilities, factories, and many more.

Have a look at http://www.safetymate.com

Regards,

Anthony

Anthony said...

Dr. Razavi's
A neighbor of mine (businessman) purchased our SafetyMate product (http://www.safetymate.com)for his business. About a year ago, his business was purchased by Google. The attorneys from Google came in and told him to take the SafetyMate product down from the wall(it sits in a cradle)and away from the business.
I found this very curious. The challenge I have with our legal system is that while this information (CPR/First-Aid instructions) could prove useful and could save a life in a medical emergency, some corporate counsel say that providing information to lay responders is dangerous and creates liability. To understand CPR/First-Aid instructions for the lay responder, we note that many protocols explains what you should NOT do to the victim in a medical emergency. What it shows me is the misunderstanding of Good Samaritan Laws, and even great companies like yours (Google) may overlook the great social value of providing tools for people to help other people in a medical emergency.

Anonymous said...

I really like it, I just have a question in the line: Compression:Ventilation ratio – Adult,with unprotected airway
What does the letter  mean?
Thanks in advance.

Dr. Taraneh Razavi said...

Sorry about the A. For some reason blogger inserted it. It is meaningless. Please ignore it.

Tina said...

Anthony
Your Safety-Mate device is a great idea, I teach CPR & sell AEDs. Frequently non-medical persons will say that 2 and even 1 year is a long time between training. Nurses and health care professionals are the exception.
Some fire companies and EMS have the Safety-Mate as a refresher.

Great product.
www.aednurses.com
Tina Silvernail, RN

Frudo said...

I know this is a medical term. CPR is unlikely to restart the heart, but rather its purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage.
I think it is a good procedure for treatment.

Regard:

AEDs