Oh stop moaning! It is getting better.
The A.R.C (Australian Resuscitation Council) has been reviewing data from America and Europe following a 5 year study.
We have always known that for C.P.R to be successful the operator had to deliver adequate compressions to the chest and for this to do perfectly the operator has to went through the CPR Course or CPR training. The current research has now shown that the focus really must be about the compressions.
The means compressions come first! Remember the point of C.P.R is to move oxygen via the blood around the body; the body contains enough oxygen in the blood to last for at least 4 minutes without extra oxygen being supplied. Hence, by commencing compressions immediately the transport of blood continues and you then supply oxygen via 2 breaths following the first 30 compressions.
As of mid January our new Basic Emergency Life Support Flow chart looks like this:
# Danger: check for any dangers to you, the bystanders or your causality.
# Response: Check for any response by using “touch & talk”
# Send for Help: If there is no clear signs of Response, send for help ASAP. The first 10 minutes are critical
# Airway: Check if the airway is blocked, if any signs of fluids roll them on the side to clear it.
# Breathing: When checking the Airway, check for signs of normal breathing, this will take about 10 seconds
# Compressions: If no normal breathing, give 30 compressions at a rate of 2 per second. For an adult you MUST push at least 5cm (about a match box).
ü Defibrillation: Attach a Defibrillator (A.E.D) ASAP and follow the prompts.
So why change it again??
We know we can hold our breath for 3 to 5 minutes without any brain damage or damage to other organs or cells, but what they do need is the blood that contains the oxygen moved around their body with the help of our compressions.
DONT delay the compressions. Now after checking for a response and calling for help if there is no NORMAL BREATHING we begin with compressions, this ensures the rapid movement of what remains of the oxygen contained within the blood.
Often first aiders are concerned about opening the airway, finding a mask lost in the glovebox or buried deep in their purse or even worse, the feeling of “ick” at having to put their lips onto those of a stranger, with or without vomit. This all takes time, time the casualty does not have.
In summary it is best explained like this:
In the older D-R-A-B-C-D sequence chest compressions are often delayed while the responder opens the airway to give mouth-to-mouth breaths or retrieves a barrier device or other ventilation equipment. By changing the sequence to D-R-S-A-B-C-D, chest compressions will be initiated sooner and ventilation only minimally delayed until the completion of the first cycle of chest compressions (30 compressions should be accomplished in approximately 18 seconds).
Other considerations that HAVE changed
Push a little harder. How deep you should push on the chest has changed for adult CPR. It was 4-5 cm, but now you should push at least 5cms deep in to the chest of an adult.
- Push a little faster. Instead of pushing on the chest at about 100 compressions per minute, you should to push at least 100 compressions per minute. At that rate, 30 compressions should take you only 18 seconds.
- Don’t stop pushing. Every interruption in chest compressions interrupts blood flow to the brain, which will lead to brain death if the blood flow is interrupted for too long. It takes several chest compressions (about 20) to get blood pressure to the level that is affective. You should keep pushing as long as you can. Push until an A.E.D is in place and ready to analyse the heart. When it is time to perform mouth to mouth, do it quick and commence compressions again immediately.
One thing that has not changed is the simple but very true motto of the A.R.C
“Any attempt at resuscitation is better than no attempt at all”