The New CPR Rule: Compressions First, Breaths Later

I came across this article from Time.com that introduces the new rules in performing Cardiopulmonary Resuscitation (CPR). Medical professionals were taught and trained to do CPR in the order of ABC, i.e., Airway, Breathing, and Circulation. First make sure that the airway of the client is free of any obstructions that can hamper in any way the giving of breathes after chest compressions are started. Ensuring that oxygen is now delivered to the brain through breathing and chest compressions, circulation of blood through other parts of the body particularly to the major body organs is now established. This is how CPR was practiced for almost 51 years (CPR was first introduced in 1960). 

Now, the American Heart Association is changing the procedure and encouraging everybody to start with chest compressions first before initiating to breathe to the client. This is the result of the studies they have conducted that:

1. victims of cardiac arrest survive from the CPR performed by bystanders who are untrained as well as those who were trained to initiate breathes first, then chest compression after.
2. social and biologic factors like the panic effect and the confidence level of the aider, usually bystanders, contributes to the total effect on how the CPR is performed to the victim. Though most of the times, the manner on how these are performed are technically not met, the outcomes of victims treated did as well as those who are trained in CPR.
3. most of the people who called 911 for help and instructions to perform CPR were most likely to follow chest compressions first and the survival rate is the same.

The medical rationale was also explained on why pumping the heart is the first thing to do. The heart needs to beat continuously and the moment the chest compressions are started, the more chances of the victim to survive is ensured. If the heart stops beating, the oxygen delivery to the brain is then compromised. 

As to the issue of brain anoxia (that is the reason why we need to breathe first before compressions), authorities said that the body cells have sufficient oxygen supply from the victim's last breath before the attack to maintain itself. The rescuer is only delaying the intake of oxygen for 20 seconds (it will take 4 minutes of oxygen deprivation before brain cells starts to die). That is why, chest compression should be started first to promote continuous heart pumping thus adequate tissue perfusion.

Though this new rule is beneficial to those who suffer from cardiac arrest and for all ages, the principle does not apply to drowning victims who are at the same unresponsive. For them, the ABC method is still applied.

On a personal note, this is something to be taught again to medical professionals and students who are beginning to learn about CPR. I would like to comment also about the hygienic factor of performing CPR. Breathing into mouths of the victims (specially strangers) is not too commendable considering that certain contagious diseases are transmitted via direct contact. With this new study, this can promote reassurance and empower more people to save lives.