Should We All Be Learning Hands-Only CPR?
The best e-mailer I know, a Cape Cod octogenarian named Jack Alden, sends me a few gems a week — helpful hints, bits of wisdom, jokes that lighten my days. A couple of weeks ago, he passed along this University of Arizona video on a new form of CPR.

At the time, all I thought was that it looked strenuous — you have to do rapidfire compressions on the heart attack victim's chest — but effective. And that it was nice that you didn't have to encounter alien saliva by going mouth to mouth with the patient.

Now there's a major new study out in the Journal of the American Medical Association suggesting that this new, simpler form of CPR can save more lives, in large part because it makes bystanders more willing to try to help. The journal's video report on its study is here:

The move toward simplifying CPR is the lead story in the Harvard Health Letter this month. Evidence in favor of the simpler CPR is growing, it says, but there are some nuances:

So we're all set: keep-it-simple, hands-only CPR is the way to go. Still, two studies published in The New England Journal of Medicine (NEJM) in July 2010 are a reminder not to oversimplify the situation. Over all, the results jibe perfectly with previous reports and further the case for taking a hands-only approach to cardiac arrest. The studies showed that people who received only chest compressions before EMTs arrived were just as likely to survive as those who received traditional CPR of compressions and breaths. But a finer analysis of the results of one of the studies showed that a small, but not insignificant, number of people did benefit from traditional CPR. They included people with "noncardiac" arrest, which usually means they had breathing problems before their hearts went haywire, as can happen with drug overdoses, asthma attacks, or near-drownings.

The Associated Press has a full feature on the study and the technique here. For tacking on the fridge, it included these steps:

_ If someone collapses, doesn't respond to gentle shaking and stops normal breathing, call 911 or tell someone else to call.
_ With the victim on his back, place the heel of one of your hands atop the other on the middle of the victim's breastbone.
_ Lock your elbows. With your shoulders over your hands, fall forward using your body weight. Press 100 times a minute. Think of the Bee Gees song "Staying Alive" for the tempo.
_ If an automated external defibrillator is available, switch it on and follow the instructions.
_ If not, continue chest compressions until paramedics arrive.

One final word. I love the "Staying Alive" tip, but it will only work if you're old enough to know the song. Suggestions for more recent 100 beat-per-minute tunes welcome. Someone should market a CPR playlist...

This program aired on October 6, 2010. The audio for this program is not available.

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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



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