When should you perform CPR?
CPR stands for cardiopulmonary resuscitation. When performing CPR, you are literally pumping the heart to maintain blood flow and oxygenation of the muscles and organs in the body. You should immediately start chest compressions if the person is unresponsive. This could be due to cardiac arrest. When someone has a cardiac arrest, they do not have pulse, and are not breathing (or not breathing normally). For those who are not trained in CPR, our best advice is to push hard and fast in the middle of the chest until paramedics, or other help arrives.
Is Continuous Compression Better than 30:2 Ratio?
A recent study (2016) measured the CPR quality during 5 minutes of chest compressions. They had some participants perform continuous chest compressions, and others perform 30 compressions and give two breaths (30:2). After 5 minutes, they found that participants were able to deliver more compressions if they did not stop to give breaths (that’s a no-brainer). However, there was a faster decline in CPR quality in this group, as compared to those who performed CPR using the 30:2 method. This means that the decline in CPR quality occurred as a slower rate among those using the 30:2 method. What is interesting about their findings is that those who performed continuous chest compressions provided more quality compressions per minute than those using the 30:2 method.
There are some limitations to this study, however. For one, the average age of their participants was 70 years old. To justify recruiting participants of this age, the authors argued that those aged 55 years or older are most likely to perform CPR. So before we generalize this finding to all populations, we must keep the recruited population in mind.
If you want to read the full article, you can Google the title: “Bystander fatigue and CPR quality by older bystanders: a randomized crossover trial comparing continuous chest compressions and 30:2 compressions to ventilations.”
Telephone CPR (T-CPR)
T-CPR refers to incidences when instructions are provided by a dispatcher to the bystander via telephone (ex. Cellphone). Most people now have cellphones with them, so T-CPR may be a really effective tool that can increase survival rates of cardiac arrests victims. Herein, I use a recent study to provide an overview of the T-CPR method.
Benefits of T-CPR?
- T-CPR Increases the rate of bystander CPR, which in turn increases the survival rates of cardiac arrests victims by 2 – 4 times.
- A Finland study showed a 11% increase (43%) in survival rate until hospital discharge of patients with ventricular fibrillation.
- Experienced dispatchers have the potential to increase the number and quality of CPR delivered.
- Implementation of T-CPR can be effectively implemented. Ex) Every third bystander in Germany has provided T-CPR. Sweden the rate is 55%.
Fallbacks of T-CPR?
- It takes a long time from the first instructed call to first chest compression (140 – 328 seconds). If instructed to do ventilations, it takes 84 seconds longer.
- There may be communication barriers between the layperson and dispatcher, which further increases the time to explain how to do CPR.
How to improve T-CPR?
- Establish standardized protocols to identify cardiac arrests. A London study showed an increase in 200% of patients correctly identified as being victims of cardiac arrests.
If you want to read the full article, Google: “Telephone-assisted CPR – A Literature Review”