Unconvinced by hands only CPR

Posted on Sep 08, 2011 in Opinion

Have you ever wondered what you would do if someone collapsed and stopped breathing? Would you immediately run over and help the victim? Or would you hang back, afraid and confused?

Organizations like the American Heart Association have started advocating a new form of CPR called “hands free CPR” which makes your help much easier to provide by eliminating the breaths normally administered in the traditional rescue model. But what does changing the model for CPR mean?

When someone goes into cardiac arrest, his or her heart stops beating. No heartbeat means that blood stops circulating. No circulation prevents oxygen from reaching important organs like the brain. Significant oxygen deprivation can lead to brain damage and death. The purpose of cardiopulmonary resuscitation (CPR) is to supply and circulate oxygen until more advanced medical attention can be received.

So why eliminate the breaths? A commonly cited reason is that people are more likely to help someone in crisis if they do not actually have to touch the victim’s mouth.

Exchanging saliva can be dangerous; diseases like mononucleosis and herpes are sometimes spread via spit. Even if the victim is not receiving additional oxygen, circulating the oxygen already in the blood could be incredibly helpful.

Additionally, a study published a few weeks ago in the New England Journal of Medicine indicates that patients had similar rates of survival with either method; however, the paper also states that interpretation is limited by possible confounding factors.

Despite ambiguities, people are taking notice. In fact, if you want to be prepared to give hands free CPR in emergency situations, there is now a handy app for that on your mobile device!

In spite of all this new information, I remain unconvinced. Replenishing the victim’s oxygen supply is an important part of CPR. Furthermore, more people might be comfortable with the idea of only chest compressions, but fear of mouth-to-mouth should not carry so much influence. There might be dangers to exchanging spit, but these are life and death situations.

One detail was almost completely ignored by the media coverage: the study design. Participants were recruited without prior consent.
If a 911 dispatcher was informed that an unconscious person was in cardiac arrest, the dispatcher would instruct the caller to perform either traditional CPR or only chest compressions. Only afterwards would the patient be informed of the caller’s participation.

If I suddenly suffered a cardiac arrest and was recruited for this study, I would be very angry that my critical condition was used to test a hypothesis. Please allow me to receive the current standard of care unless I clearly state otherwise.

Even now, after it has been ambiguously established that chest compressions without rescue breaths can be effective, I would much prefer the extra oxygen.

Rachael Rosales
Contributor
rosales@uab.edu