Untrained bystanders encouraged to do compressions only

San Antonio (March 5, 2004) – It’s something none of us wants to face – being the closest bystander when someone’s heart stops. But face it we must, because what we do in a crisis might save that person’s life.

Traditionally we were taught that cardiopulmonary resuscitation, or CPR, consists of chest compressions mingled with mouth-to-mouth breaths. But four years ago, new consensus guidelines changed the standard of care. Untrained bystanders are advised to do chest compressions only and forgo the breaths in the critical minutes before emergency personnel arrive.

First we must call 911, so that help can be dispatched and instructions can be given.

“Dispatcher-assisted CPR is practical and effective,” said Donald J. Gordon, M.D., Ph.D., professor of emergency medical technology at The University of Texas Health Science Center at San Antonio and medical director of San Antonio Emergency Medical Services. “We are in the process of trying to retrain the emergency 911 call takers about compression-only CPR for untrained rescuers. In 53 percent of the calls we get for cardiac arrest, someone at the scene knows the full CPR.”

CPR training will take place Saturday (March 6) from 8 a.m. to noon at the Alamodome, where the annual CPR Day will be held. The public is encouraged to receive free instruction in CPR. Comparable training usually costs $25. An American Red Cross or American Heart Association CPR certification card is $5 at the event.

“Three-fourths of cardiac arrests occur in the home,” Dr. Gordon noted. “CPR Day training is one of the best ways to show you love your family and friends.”

In “Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: An International Consensus on Science,” the American Heart Association and the International Liaison Committee on Resuscitation recommended chest compression-only CPR “for reasons of simplicity and elimination of barriers to action” for untrained bystanders.
Medically it makes good sense.

“When the heart stops pumping, there’s still a good percentage of oxygen in the blood,” Dr. Gordon explained. “The problem is making that blood circulate to perfuse the heart and brain. The act of pumping on the chest accomplishes that, and it also moves a small amount of air to supplement this remaining oxygen, like a bellows that moves air in and out as you push on it. So there is a certain amount of ventilation that can get into the blood during chest compression only.”

Comfortingly, most homes in urban areas are within four minutes of a fire department. “So we only have to do these compressions a short time, if we’ve called for help,” Dr. Gordon said. “That’s why I emphasize calling 911 before starting CPR.”

Fire trucks carry oxygen, a defibrillator and trained CPR specialists, and these are key links in the chain of survival. “The chain of survival is calling 911, doing compression-only CPR and, when help arrives, defibrillation,” Dr. Gordon said.

San Antonio saves 7 percent of adult cardiac-arrest victims. The national average is around 4 percent. Survival rates among U.S. cities vary according to the way each calculates and reports its own statistics, Dr. Gordon noted

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