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A Simpler Approach to CPR

If a coworker or family member suddenly collapses, giving CPR can improve his or her chances of survival. But what if you don't know CPR—or you're reluctant to perform it even if you're trained? The American Heart Association (AHA) has encouraging news for you: hands-only CPR.

"Hands-only CPR" means doing only the chest compression part of CPR. It doesn't involve any rescue (mouth-to-mouth) breaths, as does conventional CPR.

The AHA revised its guidelines in early 2008 to include hands-only CPR because it found that only a third of people who could benefit from CPR were actually getting the help they needed. A person who receives CPR in the first few minutes after collapse doubles his or her chances of survival.

The AHA found that some bystanders didn't help because they were afraid of inadvertently doing harm. Others said they felt uncomfortable giving mouth-to-mouth breaths.

After looking at statistics of heart attack victims, the AHA found that those who received hands-only CPR had about the same rate of survival as those who got conventional CPR—intervals of 30 chest compressions followed by two rescue breaths.

A quick response

The revised guidelines simplify a bystander's response to a medical emergency. If you see an adult collapse from an apparent heart attack, you should:

  • Call 911 or your community's emergency number to summon help.

  • Begin pushing hard and fast in the center of the person's chest. Aim for 100 compressions a minute.

If you are trained in conventional CPR and you are confident in your ability to give chest compressions AND breaths, the AHA says you may do either conventional CPR or hands-only. If you aren't confident in your ability to perform conventional CPR, then do hands-only.

Try to continue the chest compressions until help arrives—either someone with an AED or emergency medical staff. If possible, periodically switch off with other bystanders so that you don't become too tired. Giving good-quality chest compressions at 100 times a minute is hard work.

Training still needed?

The AHA still recommends that people get conventional CPR training, because it can be used in other emergency situations. Conventional CPR is recommended for infants and children, for adults who are found already unconscious and not breathing normally, and for victims of drowning or collapse because of breathing problems.

Also, people who have had training in CPR are more likely to give better chest compressions than people without training, the AHA says.

Still, the AHA says, giving any CPR is better than giving none.

For more information

The AHA also offers a "CPR Anytime" kit for about $30 to learn in your own home. The program takes about 22 minutes and includes The kit includes an inflatable practice mannequin. For more information, see http://handsonlycpr.eisenberginc.com/resources.html.

Publication Source: CPR: Are We Doing It Wrong? Harvard Health Letter. May 2005, vol. 30, no. 7, pp 1-3.
Publication Source: Hazinski, Mary Fran, clinical nurse specialist, Vanderbilt University Medical Center, who helped develop new American Heart Association CPR guidelines. Interview.
Publication Source: Health & You/Fall 2006
Publication Source: Nadkarmi, Vinay, M.D., specialist in critical care, Children's Hospital of Philadelphia, associate professor of anesthesia and critical care at the University of Pennsylvania School of Medicine. Interview.
Publication Source: Sayre, Michael, M.D., associate professor of emergency medicine, Ohio State University College of Medicine and Public Health. Interview.
Publication Source: Streamlined CPR Guidelines a Life-Saving Move. Harvard Heart Letter. February 2006, vol. 16, no. 6, pp. 1-3.
Author: Schogol, Marc
Online Source: Circulation http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.107.189380
Online Source: American Heart Association http://handsonlycpr.eisenberginc.com/
Online Source: American Heart Association http://handsonlycpr.eisenberginc.com/faqs.html
Online Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3011764
Online Editor: Sinovic, Dianna
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Date Last Reviewed: 12/13/2006
Date Last Modified: 5/23/2008