Search the LHSFNA website
Published: December, 2010; Vol 7, Num 7

 

CPR Procedures Revised

On October 18, the American Heart Association (AHA) announced a major revision of CPR (cardiopulmonary resuscitation) procedures, the emergency action which should be taken when a victim suffers cardiac arrest (heart attack).

Alternate description

LHSFNA Management Co-Chairman Noel C. Borck

“Every minute, someone in the U.S. dies due to sudden cardiac arrest,” says LHSFNA Management Co-Chairman Noel C. Borck.  “Many of these deaths can be prevented if appropriate action is taken in the first vital minutes.”

Unlike in the past, the revised CPR protocols recommend two procedures, one for trained medical rescue personnel and a different one for laypersons – untrained bystanders – who may be present when someone has a heart attack.

Untrained Rescuers

By employing continuous chest compression CPR – also known as hands-only CPR – and acting quickly, any person can save the life of another who suffers cardiac arrest.

Demonstrations

A one-minute video from the AHA demonstrates the technique. A five-minute video produced by the Arizona University College of Medicine also demonstrates the technique – known as continuous chest compression or hands-only CPR – while offering a comprehensive explanation.

First, call 911 or tell someone else to do so. Then, roll the individual on his or her back and check for responsiveness by shaking the victim, shouting or rubbing the victim’s chest bone hard with your knuckles. If there is only gasping or no breathing, immediate action is required. It is unnecessary and is a waste of time to remove the victim’s clothing.

Kneel by the victim’s side and place the heel of one hand on the breast plate (midway between the nipples), locating the heel of your other hand on top of the first. Lock your elbows and press from your shoulders. Compress the chest with a continuous series of rapid compressions, about 100 per minute. Press down at least two inches, then fully release the chest. Repeat quickly. Continue until emergency help arrives.

Keep in mind that it is virtually impossible to hurt the victim through your actions. In fact, if you do not act decisively, death is the likely outcome. No certification is required to perform hands-only CPR, and Good Samaritan laws protect you against legal action for trying to help.

It is important to note that quick action is necessary to save a life.  Every minute that CPR is delayed increases the chances of death by ten percent.

Note also that continuous chest compression or hands-only CPR is not suitable for infants, small children or someone who has drowned. For these persons, C – A – B CPR is necessary (see Trained Rescuers, below).

Trained Rescuers

Trained rescuers can carry out a more sophisticated resuscitation procedure so they are advised to perform C – A – B CPR (compression – airway – breathing CPR).

First, 911 must be called, and a second rescuer should search out any available automated external defibrillators (AED). Then, the victim should be rolled on his or her back and checked for responsiveness.  No more than ten seconds should be spent checking for a pulse.

If the victim is not responsive, chest compressions should be started immediately. Each compression should compress the chest at least two inches. Two inches will suffice for children and an inch and a half of infants.

After 30 compressions, the victim’s airway (through the mouth) should be checked and cleared, and two breaths should be blown into the lungs (mouth-to-mouth resuscitation).

Then, compressions should resume for another count of 30, followed by two more breaths.  The pattern should continue until an AED becomes available or an emergency response team arrives and takes over the situation. The AED should be used as soon as available, with compressions continuing right up to shocks and beginning anew immediately after each shock.

Why the Change?

The American Heart Association was cautious about revising its long-standing CPR procedures and did so only after summarizing “the international consensus summarizing tens of thousands of peer-reviewed resuscitation studies.” The consensus shows that even the slightest delay in initiating compressions – which force blood to the brain and heart – results in significantly less favorable results.

Under the old procedure, known as A – B – C, the first step was clearing air passages, followed by blowing air into the mouth. For laypersons, timidity about blowing air into another person’s mouth often delayed – and sometimes completely averted – compressions. Even for medical personnel, the ABC order failed to stress the urgency of starting compressions immediately.

The LHSFNA is revising its laminated CPR/Heimlich chart to incorporate the revised procedures. Participating local unions, signatory employers and LIUNA health and welfare funds may order new charts through the Fund’s online catalogue.

“CPR isn’t difficult,” says Borck, “and it’s something all of us should know. Become familiar with this simple technique. The life you save may be a loved one or a fellow Laborer.”

[Steve Clark]