Thoughts on Compression Only CPR

There has been a recent media push regarding a concept introduced by the American Heart Association called, “Compression Only CPR.” This means that bystanders who volunteer to assist someone who is unresponsive and not breathing should begin chest compressions and continue chest compressions without breathing for the victim.

I understand the concept, as for many lay rescuers who have not taken a CPR class or do not want to place their mouth on the mouth of an unknown individual, compression only CPR is a good alternative. However, one key element with Compression Only CPR is that it is most effective when performed on ‘witnessed’ arrests (where the patient goes down in front of the rescuers). This is because research shows in sudden cardiac arrest there is still ample oxygen in the lungs and blood, and immediate chest compressions will keep that oxygenated blood flowing to the heart and other vital organs.

What happens to the victim of a cardiac arrest which was not witnessed and the amount of time passed is unknown? This circumstance is not addressed with Compression Only CPR guidelines. Concrete evidence shows tissue damage begins after 4 minutes to a brain without oxygen, and after 10 minutes of no oxygen, significant brain death has occurred. For a witnessed arrest, once the oxygen in the body has been depleted, what then? Firefighters and ambulance personnel have barriers to protect themselves when providing rescue breaths. However, the basic lay rescuer may not have a personal barrier with them in the event of an emergency.

I encourage all individuals both professional and lay responders trained in CPR to carry personal protective barriers. They can be found on many sites but one of my favorites is the Microshield Key. It is a CPR barrier on a key chain because I always have my keys with me when I am not at home.

Be prepared and stay safe!