What does "Hands Only" CPR Mean?

Recent news outlets have been reporting that the American Heart Association has changed the CPR guidelines to “Hands Only” or “Compression Only” without rescue breaths.  As we all know the media uses short sound bites and rarely report the story in depth.  In Paul Harvey’s words here is…the rest of the story.

 

“Hands Only” CPR is an addition to, rather than a substantive change to the AHA CPR guidelines.  The American Heart Association and the American Red Cross previously recommended “Hands Only” CPR for dispatcher-assisted CPR when bystanders were provided instructions by emergency services dispatchers.  The recommendation for compression only CPR is attempting to address the issue of laypersons who are:

 

Ø      not trained in CPR

Ø      unable to perform CPR with rescue breaths

Ø      unwilling to provide rescue breaths

Ø      trained in CPR but not confident in his or her ability to provide quality CPR

 

Unfortunately bystander response and performance of CPR remains low in most cities, reported to be between 27% to 33%.  In an attempt to increase bystander response rates, this technique simplifies the skill of CPR for an untrained, unwilling or responder unable to deliver rescue breaths.  This also simplifies emergency services dispatch’s ability to give instructions to an untrained responder.  However, a rescuer performing effective full CPR (using an AED where available) is always providing a victim of cardiac arrest his or her best chance of survival.

 

This is an attempt to better address the issue of bystander response.  Bystander reluctance to perform CPR is affected by a number of factors:

               

Ø      Panic

Ø       Not being trained in CPR

Ø      Fear of causing harm

Ø      Concern of disease transmission (in a relative small number of instances)

 

In 2005, the CPR guidelines were changed from a ratio of compressions to rescue breaths of 15:2 to 30:2.  This change was implemented to reduce the number and duration of interruptions to chest compressions.  The ideal interval should be no more than a few seconds.  When performing ventilations, untrained or unsure rescuers may interrupt chest compressions for a significantly longer duration resulting in the delivery of significantly fewer compressions over time.

 

There are limitations to the recommendation of “Hands on CPR”.  It is appropriate for most but not all cardiac arrest victims.  However, it is not appropriate for pediatric victims, victims of drowning, trauma, airway obstruction (commonly referred to as choking), and other respiratory emergencies resulting from problems such as acute respiratory disease or drug overdoses. 

 

The best case scenario is always a responder trained in full CPR.  A bystander that is confident in his or her ability to properly perform high quality CPR consisting of chest compressions of proper depth and rate together with rescue breaths will be able to perform efficient CPR when the need arises and in turn more lives will be saved.

 DISCLAIMER

Although all information and recommendations on this website have been compiled from sources believed to be reliable, Safety Training Associates makes no guarantee as to, and assumes no responsibility for, the correctness, sufficiency, or completeness of such information or recommendations, other or additional safety measures may he required under particular circumstances. For specific information as to how particular regulations or laws affect your organization it is always prudent to seek advice from your organizations legal counsel.