Hands Only CPR: Maximizing the Value of CPR

Over the years the procedure of performing CPR has gone through a great deal of evolution. While the principle is still the same — pump the heart so blood circulates — the number and rate of compressions along with the number and depth of breaths have undergone revisions. This has occurred because of the increased knowledge of which methods are most affective at saving victims which have suffered cardiac arrest (when the heart stops).

The emphasis has shifted from more breaths to more compressions. And over the past few years there is even a recommendation that hands only CPR is sometimes more beneficial, or necessary, than combining CPR with breaths.

The norm right now is to perform 30 compressions to 2 breaths, repeatedly, when performing CPR. However, there may be some situations where a rescuer can't, or doesn't want to, give breaths, or even situations where the victim will benefit more from compressions only.

For example, a rescuer may feel adverse to performing rescue breathing on a victim. This may be due to personal reasons, lack of rescue breathing equipment, the fear of disease transmission, or even injuries to the mouth and nose which would make the procedure more difficult. Therefore, instead of having a potential rescuer walk away from helping someone, this rescuer may be more inclined to help if they performed hands only CPR.

Also, in situations where a victim has suffered a sudden cardiac arrest what they really need the most is blood circulation. Lack of oxygen is not the issue, in fact there is still plenty of oxygen in the blood. What is needed is to circulate this blood/oxygen. And the best way to do this is by compressions. In fact, some may argue that wasting time giving breaths is detrimental in such a situation, as it delays the commencement of compressions.

While the major agencies that offer CPR programs have not removed the breaths from the protocol, they have acknowledged that at times hands only CPR may have certain benefits. And with time, it will become more acceptable.

Note, however, that in situations where the victim's heart has stopped because of unconsciousness hands only CPR is not going to be as beneficial, because the victim lacks oxygen. This would included cases such as: drowning, choking, suffocation, medical emergencies such as asthma or anaphylaxis.

Things to Remember

  • CPR must only be performed on someone that is unconscious and not breathing.
  • The present protocol is:
    • Check for breathing for no more than 10 seconds.
    • Give two regular breaths (just enough to make their chest rise).
    • Perform 30 compressions (about 4-5cm deep on an adult, at a rate of 100 per minute).
    • Repeat 30:2 until help arrives or until something chances, in which case you reassess.
  • The chance of survival greatly depends on:
    • How soon someone begins CPR.
    • How soon an AED is used.
    • How soon paramedics arrive.
    • How quickly the person receives advance medical care.
    • And, of course, how severe their situation is.
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