Many bystanders who witness a person collapse are hesitant to perform cardiac pulmonary resuscitation (CPR) because they are not appropriately trained or reluctant to perform mouth-to-mouth breathing. Bystander CPR doubles the chance of survival from a cardiac arrest. The American Heart Association issued new guidelines in March 2008 to address these concerns.
What to do if Someone Collapses
If you witness someone collapse, call (or have someone else call) emergency medical services immediately. In the United States, dial 911 on any telephone. Next, start pushing on the chest (compressions) with two hands in a rapid and firm manner until help arrives. Mouth-to-mouth breathing should also be done if you are trained in this technique and feel comfortable doing so. If you choose not do the artificial breathing, you should still perform the chest compressions.
More Chest Compressions are Better
Chest compressions are better than nothing. If you are trained and feel comfortable, you can add artificial breathing (mouth-to-mouth). Traditionally, those who provide CPR were instructed to give both chest compressions and breaths in a 15:2 ratio. The newer guidelines advise giving significantly more chest compressions relative to breaths (30:2). It turns out that the time spent interrupting compressions to give breaths may be better spent giving more compressions.
By giving more chest compressions, a greater amount blood flow is delivered to the heart muscle. If the heart should recover after a cardiac arrest, the extra blood flow provides energy and allows for restoration of normal contraction. Conversely, if compressions are interrupted, the recovering heart may not be able to pump once restarted.
When is Rescue Breathing Critical?
It’s important to note that rescue breathing is especially critical if the cause of cardiac arrest is predominantly due to a breathing, or respiratory, problem such as drowning or choking. Additionally, the new guidelines do not apply to situations in which a person’s collapse is not witnessed and to children in cardiac arrest. These individuals should always be given rescue breathing.
Source:
Sayre MR, Berg RA, Cave DM, et al. Hands-Only (Compression Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest. A Science Advisory for the Public from the American Heart Association Emergency CAardiovascular Care Committee. Circulation 2008: 117.