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Paramedic’s Corner: Cardiopulmonary Resuscitation (CPR)
Paramedic’s Corner: Cardiopulmonary Resuscitation (CPR)

Ambulance Director Gary Carmack
Recently a reader asked me to explain the current CPR changes. A lot of people ask or comment about a change that is very much misunderstood — that CPR is now done by doing chest compressions only. I’ll explain what the American Heart Association (AHA) intended regarding this matter.

As explained by the name (“cardio”=heart, “pulmonary”=lungs), cardiopulmonary resuscitation is still the most optimal when both rescue breathing and chest compressions are done.

However, according to the American Hospital Association, following clinical studies, survival rates were better with chest compressions only than with no CPR at all, but were best with compressions and ventilations. Some animal studies suggest that rescue breathing is not essential for the first five minutes of adult CPR. Laypeoople should be encouraged to do compression-only CPR if they are unable or unwilling to provide rescue breaths, although the best method of CPR is compressions coordinated with ventilations. (AHA, Guidelines CPR and ECC, page IV-27).

In other words, since many people can’t or won’t do mouth-to-mouth, it is beneficial for the layperson to start chest compressions in the adult rather than to do no CPR at all.

The current chest compression ratio is 30:2, meaning 30 chest compressions to 2 rescue breaths. It is important to do the compressions fast and hard at 100 times per minute and for the chest compressions to be uninterrupted. However, it is critical to get a defibrillator en-route if the patient is to survive.

This is what I highly recommend if you want to be ready to help someone in cardiac arrest: take a CPR class.

Every community needs many laypeople to do CPR until the ambulance or fire truck arrives. The Pulaski County Ambulance District will soon implement a program in which citizens can come to the district on “CPR Day” and get CPR training. I will announce when this program is ready as I have to get a few more of our staff AHA CPR Instructor certified.

Learn the signs and symptoms of a heart attack and call 911 to get the paramedics there early. Often sudden cardiac arrest can be prevented by the paramedic’s care. It is better to prevent the cardiac arrest.

If you are present when someone needs CPR, yell for help and if an automated external defibrillator (AED) is in the building or close, immediately tell someone to get the AED while you start CPR. Call 911 and get the paramedics for early advanced care. If you are alone, call 911 (early access) and get an AED coming, then CPR.

For cardiac arrest, the AHA has what is called the Adult Chain of Survival: Early access, early CPR, early defibrillation, and early advanced care.

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