Lives Made Better | winter 2011

New CPR Guidelines:
Chest Presses First, then Breaths

The American Heart Association has issued new guidelines for CPR, essentially switching the order for two key actions used in emergency situations. Rescuers are now advised to start with hard, fast chest presses even before giving mouth-to-mouth.

This is an extension of guidance the AHA has issued in recent years, putting more emphasis on chest pushes for sudden cardiac arrest. In 2008, the heart group advised that untrained bystanders, or those unwilling to do rescue breaths, could do hands-only CPR until paramedics arrive or a defibrillator is used to restore a normal heartbeat.

Now, the group says everyone from professionals to bystanders who use standard CPR should begin with chest compressions, instead of opening the victim’s airway and breathing into their mouth first.

The previous method, known as ABC training (Airway/Breathing/Compressions) emphasized making sure the victim’s airway was clear and administering two breaths, followed by chest compressions. But researchers have concluded that this delayed vital chest presses, which act like a “backup” heart and keep the blood circulating.

In fact, some researchers argue that chest compressions are so important that they recommend using only that method, with minimal interruptions and skipping mouth-to-mouth. Under the revised AHA guidelines, rescuers using traditional CPR should start chest compressions immediately—30 rapid chest presses, then two breaths. For compressions, put one hand on top of the other and push hard.

The change applies to adults and children, but not newborns. For infants, the traditional ABC approach is still recommended—two breaths, covering both mouth and nose with the adult’s mouth, followed by 30 compressions. Use two or three fingers for compressions, rather than the whole hand.

A CPR training course is highly recommended to develop this lifesaving skill.