A Better CPR

By Dr. Sanjay Gupta

Most of us have learned at least the basics of cardiopulmonary resuscitation, or CPR, at some point in our lives. The layperson's--and sometimes the doctor's--emergency treatment of choice when someone goes into cardiac arrest, CPR involves using the heel of the hand to push deeply into the victim's chest, while administering periodic mouth-to-mouth breaths. But the sobering fact is that the procedure just doesn't work very well; in fact, almost 95% of cardiac-arrest victims die before they reach a medical center. In light of a stat like that one, the American Heart Association (AHA) has decided to change the commonly practiced CPR protocol and, it hopes, save a few more lives in the bargain.

The first thing you ought to do when faced with a person suffering cardiac arrest is to call 911, if possible, and that recommendation remains unchanged. You then immediately begin administering CPR, which, according to the old rules, consists of 15 chest compressions, followed by two mouth-to-mouth breaths, then another 15 compressions, another two breaths and so on. The new guidelines call for raising the compressions from 15 to 30, while keeping the two breaths the same.

That may sound like a simple change, but it was based on the work of nearly 400 cardiac specialists reviewing thousands of studies of heart attacks. Turns out that with all the shifting back and forth between chest compressions and mouth-to-mouth breaths, valuable time was being lost. According to the AHA's Dr. Michael Sayre, the new guidelines place more emphasis on the heart and are also simpler. "Push hard, and push fast" is how he put it.

The increasing availability of defibrillators in homes and businesses adds another wrinkle to the rules. Previously, it was recommended that if you have a defibrillator nearby, three bursts of electricity be given sequentially, followed by CPR. Now just one shock is recommended, followed by CPR for 2 min. before another shock is given and so on. Remember, the emphasis is more on the chest compressions.

If you are still a little confused, the procedure is easy to learn. The first revised CPR classes will be available next spring. You can also go to the AHA website (www.americanheart org and purchase the "CPR Anytime" kit for $30. It comes with a mannequin, a DVD and an instruction manual. You can learn CPR in as little as 22 minutes. It may be the most valuable 22 minutes you have ever spent.

With reporting by With Matt Sloane/Atlanta