For nearly 40 years, CPR guidelines have trained people to follow these simple A-B-C instructions—tilt the victim's head back to open the airway, then pinch their nose and do a succession of breaths into their mouth, and finally perform chest compressions.
But now, the AHA says starting with the C of chest compressions will help oxygen-rich blood circulate throughout the body sooner, which is critical for people who have had a heart attack. With this shift, rescuers and responding emergency personnel should now follow a C-A-B process—begin with chest compression, then move on to address the airway and breaths. This change applies to adults, children, and babies, but does not apply to newborns.
The revision is a part of the 2010 emergency cardiovascular care report published by the AHA., an organization that reviews its guidelines every five years, taking into account new science and literature. Although the changed procedure will take some time to reach what Monica Kleinman, the vice chair of the AHA's Emergency Cardiovascular Care Committee, calls "front-line people", there is a plan in place to implement the recommendations as soon as possible to their training network, medical staffs, and first-responders.
"The sooner chest compressions are started, the more likely there will be a better outcome," Kleinman announced. "Studies performed in labs as well as large-population studies have shown that people do better if they get chest compressions within four minutes."
That four minutes is the amount of time it could take for emergency crews to rapidly respond, Chicago firefighter and CPR instructor Kelly Burns notes. Until then, he stresses that any CPR bystanders perform can make a difference.
"Early activation is critical," Burns says, especially in cities where traffic and walk-up buildings can slow even the fastest respondents during a trauma where every minute counts.
When someone needs CPR, the very best reaction is a quick one, he says.
"In a perfect world, someone else calls 911 while you start chest compressions on the person in need," he advises. According to Kleinman, however, only about one-third of victims of cardiac arrest get assistance from bystanders.
Despite changing guidelines, outdated training, or any confusion in the moment, Burns says that no one who tries CPR is faltering.
"People are reluctant to jump in and help, especially if the person is not a family member or friend," Burns observes on a weekly basis. "The only mistake a civilian can make in these situations is waiting and not doing anything at all."
To that end, the new AHA guidelines are meant to help anyone who encounters this kind of emergency—the idea being, if they know better, they will do better.
5 potentially life-saving notes to remember about the new C-A-B method of CPR:
1. There are no mistakes when you perform CPR.
"One thing most people don't know, " Kleinman says, "is that there is almost nothing you can do [during CPR] to harm a person in cardiac arrest except delay responding."
Starting with chest compressions is now viewed by the AHA as the most effective procedure, and all immediate assistance will increase the chances the victim will survive with a good quality of life.
If one person calls 911 while another administers CPR, as Burns recommends, emergency operators will give informed instructions over the phone as well as dispatch aid to the scene.
2. All victims in cardiac arrest need chest compressions.
The AHA asserts that people having a heart attack still have oxygen remaining in their lungs and bloodstream in the first few minutes of cardiac arrest. Starting chest compressions first thing pumps blood to the victim's brain and heart sooner, delivering needed oxygen. This new method saves the 30 seconds that people performing CPR used to take to open the airway and begin breathing under the old guidelines.
3. It's a myth that only older, overweight men are at risk for a heart attack.
"Equal numbers of women and men have heart attacks," Kleinman reports. Sufferers are primarily adults.
Although infants and children are far more likely to require CPR due to accidents than cardiac arrest, it is important to know how administer care to them. (You can learn how to perform CPR on infants and children with this kit produced by the AHA or by signing up for one of their training sessions.)
4. Nearly all cardiac emergencies occur at home.
"Ninety percent of events take place at home. If you perform CPR in your lifetime, it's probably going to be for someone you love," Kleinman reveals.
5. Training is simpler and more accessible than you think.
Learning CPR has never been hard, Kleinman says, but guideline changes in the last ten years have reduced the number of steps and simplified the process even more.
Traditional CPR classes (listed here on the AHA website) are accessible for many people at local schools and hospitals.
Kits are also available to complete in the privacy of your own home or workplace. Kits available through the AHA include inflatable, disposable mannequins and a training DVD.
"Anybody can learn to do CPR. It's clearly important for saving lives, and now it is easier than ever," Kleinman asserts.
Have you ever administered or received CPR? Would you jump in to the C-A-B method if you saw a person in need?
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