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Discover Medium. Make Medium yours. Studies have identified chest compressions as the critical element during the first few minutes. In most circumstances people can survive for four to five minutes longer if the body temperature is low without having their blood reoxygenated. University of Arizona researchers published a study in in Circulation that pointed out the problem with current guidelines.
About 50 first-year medical students were trained in basic CPR, then tested on mannequins soon afterward and six months later. Even right after the training, two quick breaths took an average of 14 seconds — time not available for chest compressions. But could eliminating the ventilations cost lives? Not according to a study done in Seattle. Fire department dispatchers there instructed rescuers at the scene of an apparent cardiac arrest to perform, at random, either compression-only CPR or standard CPR.
Among hundreds of cardiac arrests, survival rates were the same in both groups. The success in Seattle depended on quick response times by the fire department, he says, asking "What happens to the patient after four or five minutes" if there's no ventilation?
Eisenberg is undertaking a compression-only CPR study in suburban Seattle. One possibility is keeping the ventilations but cutting the rate down to, say, once or twice every compressions.
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Every five years, CPR experts from around the world gather to review the science, but individual "resuscitation councils" decide how to translate scientific findings into practical guidelines. The expert meeting was held in January in Dallas, but its conclusions are being kept under wraps until November , when they'll be published in Circulation.
The AHA is following up with new guidelines in December In , it eliminated the recommendation that lay rescuers check the victim's pulse. The absence of a pulse is arguably the best sign that the collapse was actually caused by cardiac arrest and not something else see chart below. But it turns out that, as many studies show, lay rescuers and even some health professionals!
The AHA that year also simplified the guidelines for chest compressions and compressions-to-ventilations ratio.
It's both frightening and confusing when someone suddenly collapses, especially if it's a loved one. Don't assume it is cardiac arrest. More people lose consciousness from fainting syncope and seizures than from cardiac arrest. Here are some ways to distinguish between the causes of sudden collapse.
People lose consciousness and have no pulse or a very weak one although current guidelines say laypeople should not check for a pulse. Although breathing generally stops, it may continue for several minutes after the heart stops. There may be a few seizure-like movements as the brain becomes short on oxygen hypoxic. Note that a heart attack rarely causes loss of consciousness unless it leads to cardiac arrest. Heart attack symptoms include heavy pressure in the chest, shortness of breath, and lightheadedness. First aid tips: Call before you do anything else. Shocks from an AED may restart the heart.
But if you go to find the defibrillator and it's not nearby, you could lose precious minutes. People lose consciousness and may turn ashen, but they keep on breathing. The cause is a sudden drop in blood pressure that temporarily leaves the brain short of blood, so the pulse may be very weak. First aid tips: Don't support the person in a chair or in an upright position.
Think of fainting as a protective measure: Nature makes us go to the ground to spare the heart from fighting gravity as it works to restore blood flow to the brain. Lay the person down and elevate the feet. If there is vomiting, roll the person on his or her side to prevent choking. Seizures are caused by sudden or irregular electrical activity in the brain. Conditions like epilepsy cause seizures, but they can also be triggered in otherwise healthy people by a fever, sleep deprivation, an infection, or dehydration.
In most cases, the sudden jerking motions last only a couple of minutes. Afterward, people often become groggy and may fall asleep. They usually wake up in 3—5 minutes. First aid tips: Seizures often look much more dangerous than they actually are, so stay calm. A person who is having a seizure should not be restrained, and nothing should be put in his or her mouth. If possible, it's important to protect the person's head. The classic symptoms include numbness on one side of the body or face, slurred speech, loss of vision in one or both eyes, and dizziness. When a stroke is caused by a hemorrhage in the brain rather than the more common kind caused by a blood clot, the symptoms can be rapidly followed by a loss of consciousness, but the symptoms almost always come first.
CPR: Are we doing it wrong?
First aid tips: Call immediately, and get treatment as quickly as possible. Chances of recovery improve tremendously with early intervention. You can't offer much in the way of first aid; just stay with the person and keep him or her comfortable. The AED presents a tough choice. Eisenberg describes the AED as a more "definitive therapy. On the other hand, if you run around looking for an AED while neglecting CPR, you could lose valuable lifesaving minutes.
From a cost-benefit point of view, the value of a home AED is debatable. If you do decide to take this gamble, at least make sure you know how to use the defibrillator and exactly where you have stored it. Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles.