American Safety & Health Institute on Compression-Only CPR
The American Safety & Health Institute (ASHI) will be releasing new support materials for Instructors and students later this week to reflect recent changes in guidelines calling for compression-only CPR in the event of a witnessed adult collapse in an out-of-hospital setting.
Earlier this week, the American Heart Association amended and clarified guidelines for bystanders who witness an adult out-of-hospital sudden cardiac arrest. The AHA released an advisory calling for compression-only CPR by untrained responders or those who are not confident in performing conventional CPR, which combines chest compressions and rescue breaths. The AHA science advisory, “Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest” was published in the March 31, 2008, edition of the journal Circulation
ASHI concurs that compression-only CPR is a viable alternative in certain situations to conventional CPR, which combines chest compressions with rescue breaths in a ratio of 30 compressions to two rescue breaths. Our training programs follow science treatment recommendations and guidelines based on the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
. Since the AHA advisory amends these specific guidelines, we have begun to update our training materials and class presentation materials to reflect the amended guidelines. New support materials addressing compression-only CPR will be available beginning Friday through the login section of our website, www.ashinstitute.org
At this time, the AHA is not changing its recommendation for healthcare providers and other professional rescuers who received healthcare provider basic life support training.
The concept of compression-only CPR has been widely discussed since the 2005 guidelineswere released. Since then, ASHI student materials for lay-rescuers have included the statement, “If a rescuer is unwilling or unable to provide rescue breathing, chest compressions alone are better than nothing.” It is important to note that compression-only CPR is not
recommended for children and infants, adults discovered unresponsive, and non-heart-related arrests such as drowning victims, and persons suffering from a drug overdose.
For most ASHI Training Centers, when conducting training for workplace or healthcare providers, there should be little change in what is taught.
“The real challenge in CPR courses now will be teaching students, especially laypersons, to differentiate the cause of arrest so they understand when rescue breaths may improve outcome,” says Executive Program Director Ralph Shenefelt. “For example, ‘Is it suffocation or SCA?’” He adds “Yet, even with this in mind, the advisory committee – weighing the advantages and disadvantages – made the following recommendation, ‘All victims of cardiac arrest should receive, at a minimum, high-quality chest compressions.’”
By eliminating the apprehension associated with the need to ventilate, compression-only CPR may encourage more bystanders to take action and attempt CPR when an adult collapse is witnessed. Studies show that when an adult is seen to collapse, compression-only CPR can be as effective as conventional CPR. Regardless of the approach, high-quality chest compressions with as few interruptions as possible help keep blood pumping from the heart to the lungs and brain, increasing the odds of successful resuscitation.