CPR

Many American's know what what CPR is, even if they do not know how to do it. But, how many people actually know what the letters CPR stand for?

Cardiopulmonary Resuscitation

Cardio = Heart

Pulmonary = Lungs

Resuscitation = Reanimation...returning of life...etc.

As part of first aid class and every higher-level class I have taken since then, I have always been taught to check the ABC's and in that order. Airway, Breathing, and Circulation. They are important in THAT order. Your heart may be pumping, but without an open airway and respirations, the heart won't be helpful for very long.

Americans are learning CPR in greater and greater numbers. But, the public is also becoming a lot more aware of communicable diseases. This has caused a crisis for the patient in need of aid when only bystanders are around. People are doing nothing. Even when they may have at least a decent idea of what to do. It seems that people are afraid to do rescue breathing. Honesty, I don't blame them. Without a barrier between you and the patient, there is a good chance you could swap some germs...and maybe lunch.

So, it seems this thinking is now effecting how people are being trained to do CPR. The use of disposable masks and other barriers has been around for sometime. But, the big change that is just rolling out is scaring many professional rescuers. For CPR, the importance of ABC is being switched around to CAB.

I can understand training someone to at least do compressions if they are in a situation where they are nervous to do respirations. Yes, the residual Oxygen in the system will be circulated around. But, toxic Carbon Dioxide will build up if not given a chance to escape though respirations.

The American Heart Association has a major sway on how CPR is done in this county. With their current revision in their guidelines, they seem to hold the risk of alienating the professional rescuers. Below I have linked to a FOX News article that seems to show a fairly positive outlook on the new guidelines. I have also linked to a blog entry that goes into great detail about why many medics think the whole thing is messed up. Though the blog may be way to technical for readers outside the medical world, I highly suggest everyone read both.

My take on it?

I am about to get my CPR instructor certification for the American Heart Association. I will teach the new guidelines, as I am required. But, I will also talk about the impact of these guidelines depending on the level of my audience. If you have no medical experience at all and a stranger codes in front of you...Call 911 FIRST! After that, do everything you feel comfortable doing. If that is only compressions, so be it. If that is lots and lots of compressions and only a few breaths. Thank you. But, please realize that as professional rescuers, when we arrive, we are expected to deliver care at a higher level. This means making sure we do effective compressions and BREATHE FOR THE PATIENT. I recommend Oxygen delivered though an ET Tube/Bag-Valve. But, if you are a Basic service, please at least to a Bag-Valve-Mask. The key is to assess the patient and do what it best for that patient. Guidelines are just that guidelines (NOT LAW) ...follow your local protocols, they are what will help you keep your job...and hopefully save a life.

Like I said, read the articles.

Fox News

Paramedic Blog - 11/30/05