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Jewish World Review
Ask the Harvard Experts: No longer be intimidated. You can save a life!
Howard LeWine, M.D.
'Hands-only' makes CPR much simpler
Q: Recently, I watched someone next to me faint. Fortunately, it was nothing more serious. But I froze. I yelled out, "Call 911!" but was afraid to do anything else. What if the next time I witness a cardiac arrest? I heard that CPR is not as complicated as it used to be. Is that true?
A: Yes, CPR has been made much simpler. And don't feel guilty about not knowing what to do. Even those who have taken CPR classes usually can't immediately recall exactly what to do at that moment. In addition, there is the fear of doing it wrong. Many people also are uncomfortable putting their mouths on a stranger's mouth.
The American Heart Association (AHA) recognizes that unless CPR can be made a lot simpler, most people wouldn't do it. So now the AHA recommends "hands-only" CPR for everyone except people who are trained and comfortable with providing standard CPR. Hands-only CPR means you do only chest compressions, without breathing into the mouth.
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The new AHA recommendation makes sense. There's no question that the body needs a constant supply of oxygen. That's why earlier CPR guidelines called for 2 breaths for every 15 chest compressions. But positioning yourself to pump the chest and deliver breaths means losing valuable seconds. It requires getting the head in the right position and then clearing the mouth. Doing all this correctly is a challenge for anyone.
Most victims of a sudden cardiac arrest already have a fair amount of oxygen in their lungs and bloodstreams. The people aren't moving, so they aren't using much oxygen. That means it takes a few minutes for their bodies to use up that stored oxygen. Meanwhile, a little bit of air is passively pushed out and pulled in with every chest compression a rescuer performs.
But is hands-only CPR at least as effective as the old CPR? The results of a recent study suggest that hands-only is even better at reviving a person from cardiac arrest. In fact, if there is a defibrillator (an electrical heart shocker) close by, potentially 1 in 2 deaths could be prevented. Now saving 1 out of 5 people in the field is considered highly successful.
The new message: CPR is simple. All you really need to know: Put your hands on the middle of the person's chest, push hard and relax. Repeat the push-relax cycle twice a second. Don't stop.
And don't worry about doing it wrong. Any CPR is better than no CPR.
(Howard LeWine, MD, is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
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