Heart Association Supports Compression-Only CPR

It's all right to skip mouth-to-mouth resuscitation and use hands-only compression when performing CPR on adults, according to the American Heart Association. Dr. Gordon Ewy, a longtime advocate of compression-only CPR, talks about the change in guidelines.

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MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

A reversal of guidance now from the American Heart Association. If you come to the aid of an adult victim of cardiac arrest, the association now says it is best to apply hands-only CPR, or cardiopulmonary resuscitation. For many years, the recommended first aid has been conventional CPR, which combines mouth-to-mouth resuscitation with pressing on the heart attack victim's chest. Well, the recommendation in the association's journal says skip the mouth-to-mouth part; hands-only works just as well.

Well, Dr. Gordon Ewy of the University of Arizona has been proposing this since the early 1990s and joins us now from Tucson.

And Dr. Ewy, I gather the research now shows that there's no better result for using the mouth-to-mouth in addition to chest compression.

Dr. GORDON EWY (Director, University of Arizona Sarver Heart Center): Yes, that's correct. Because if you or I were to collapse right now, our blood would have plenty of oxygen in it. And when someone starts compressing the chest, the flow to the heart and the brain is so marginal that if you stop for anything, including breathing, it decreases the chance of the patient surviving.

SIEGEL: Well, as you understand it, what now is the recommendation to people who happen to see someone who has collapsed?

Dr. EWY: Well, you need to tell the difference between a cardiac arrest and a respiratory arrest. If you pull someone out of a swimming pool, that's a respiratory arrest. A cardiac arrest is an unexpected collapse in an individual who is non-responsive - you shake him a couple times, holler their name -who has abnormal breathing. And there are only two types of abnormal breathing. They're either not breathing at all, or they have this gasping, snoring-type of respiration that sounds likeā€¦

(Soundbite of man belching)

Dr. EWY: That is good. Because if you start chest compression, most of them will continue to gasp and you don't have to worry about ventilation. But there's enough oxygen in the blood for a long time if you just do chest compression.

SIEGEL: You eventually want to get a defibrillator or something, don't you? More significant than just pressing on the person's chest?

Dr. EWY: Yes, because chest compression-only or hands-only CPR will not save the patient. It slows the act of dying and buys time, so if there is an automated external defibrillator, you get that and follow the directions. They're very simple; an eighth-grader can do it without difficulty.

You call 911 and do chest compression only until the paramedics arrive and then they can give the proper treatment, which will include defibrillation.

SIEGEL: And if you administer chest compression, hands-only CPR, do you have some mental devices for us to bear in mind as to how one should best do that?

Dr. EWY: Yes. It's actually very simple. You put the heel of one hand on top of the other hand. Aim for the center of the chest, usually between the nipples. Lock your elbows, that means put your arms straight. You put your shoulders directly above the center of the chest and you fall. Compressing the chest one and a half to two inches and then you come up off of the chest after each compression. And it's a hundred per minute, which is pretty fast, but there are a lot of songs that are written at a cadence of a hundred a minute, one of which is "Stayin' Alive."

(Singing) Ta, da, da, da, da, da, da, da, da, da, da, stayin' alive.

SIEGEL: Well, Dr. Ewy, thank you very much for this guidance. And also for helping us to never hear the Bee Gees singing "Stayin' Alive" in quite the same way ever again for the rest of our lives.

Dr. EWY: Thank you.

(Soundbite of song "Stayin' Alive")

SIEGEL: It's Dr. Gordon Ewy of the Sarver Heart Center at the University of Arizona College of Medicine. The American Heart Association says now, assistance for a cardiac arrest victim, an adult they say, should be hands-only CPR not conventional CPR.

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