When I was a nursing student, my boyfriend's grandmother suffered a cardiac and respiratory arrest in front of me. After a second or two of shock and saying to myself I can't believe this is happening to me, I told my boyfriend to call 9-1-1 and then I moved her from the bed to the floor and started CPR. After a few series of chest compressions and rescue breathing, she vomited into my mouth. They certainly didn't teach me that could happen in the CPR class I had! Once the paramedics arrived, they defibrillated her, got a rhythm and pulse back and they transferred her to the hospital. When I told several people what had happened, they told me they could never have done CPR on someone because they could never get the ratio of compressions to ventilations right, and they feared catching something from the victim or having the victim vomit in their mouth. As we now know, lay people are often hesitant to do CPR for just these reasons.
Today The New England Journal of Medicine published an article that will hopefully change laypersons perceptions of doing CPR. The multicenter, randomized trial looked at 1,941 patients who were randomly assigned to one of two groups, to receive chest compresions alone or to receive chest compressions plus rescue breathing. According to the study, the results support a strategy for CPR performed by laypersons that emphasizes chest compressions and minimizes the role of rescue breathing.
What does this mean for layperson CPR? Chest compressions are the priority, press hard, press fast, and don't stop until the person wakes up, the rescuer gets too tired to continue, or help arrives. It will be interesting to see if more bystanders will be willing to jump in and perform chest compressions on people who cardiac arrest outside the healthcare setting. Giving a victim a little "push" may be just the thing to improve their future.
Post by Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC