Mouth-to-mouth is old hat — new 'hands only' CPR saves lives

Chiropractor saves a life with his hands

By Thomas Lamar, DCCCEP

It started out as a typical February day at the gym for Temecula, Calif. chiropractor Jared Hjemstand, D.C. and his 15-year-old son Josh – that is until 49-year-old Garth Goodall collapsed in front of them while working out.

So what did Dr. Hjemstand do? What any like-minded chiropractor would. He directed his son to call 911 then rolled up his sleeves and utilized a new “Hands-Only” technique, he had just read about in a medical journal, and saved Mr. Goodall’s life. No, this was not a newfangled chiropractic adjustive technique, but rather a revolutionary, simplified version of CPR that has just been blessed with the endorsement of the American Heart Association (AHA), along with support from the American Red Cross.

“Hands-Only CPR,” a technique that does away with the sometimes confusing breath-to-chest compression ratios, instructs you to simply “push hard and fast” on the middle of a person’s chest until help arrives.

The technique, it turns out, is not new by any means – with origins dating back at least 15 years. Apparently, though, compelling research was not present to give it an official endorsement. Ironically, CPR guidelines have been “inching” their way towards this hands-only approach, as evidenced by guideline updates in 2005 that changed the ratio of compressions to breaths from 15 to 2 to 30 to 2 – with the caveat that those “unable or unwilling” to administer the breath portion could do compressions only.

Now, in 2008, with expected guideline updates not due for another two years, the AHA made the unusual decision to make changes now when three studies came out last year showing that Hands-Only CPR was as good as traditional CPR. Their official recommendation appeared in the American Heart Association’s journal Circulation March 31 (www.circ.ahajournals.org).

It is important to note that Hands-Only CPR does not totally replace the traditional CPR method. In fact, those traditionally trained to utilize compressions and breaths are encouraged to use them if they feel confident doing so. With this new, simplified technique, however, officials are hoping to spurn those who have not been trained, or perhaps doubt their skills, to jump in and lend a hand. “Something is better than nothing,” Dr. Michael Sayre, a professor of emergency medicine who headed the committee that made the recommendation, stated in an Associated Press article.

Hands-Only CPR is only to be performed on adults who unexpectedly collapse, stop breathing, and are unresponsive. The odds are that this person is in cardiac arrest. Under these circumstances, their lungs and blood will contain enough oxygen to keep their vital organs healthy for the first few minutes – if (and only if) someone steps in and applies high quality chest compressions (100 per minute) to circulate this oxygen.

Taking this kind of action more than doubles the victim’s chance of survival. If this type of help is not administered, their chance of survival, according to the AHA Hands-Only Web site, is nearly zero.

The Hands-Only approach is not to be used on infants and children, adult victims who are unconscious and not breathing normally, and any victims of drowning or collapse due to breathing problems. For these situations, the AHA recommends the traditional rescue breathing protocols of CPR.

So, to review: if you see an adult suddenly collapse, you need to remember two things. 1) Call 911; and 2) push hard and fast in the center of their chest until paramedics take over, or an AED (automatic external defibrillator) is available to restore a normal heart rhythm.

While this new technique does not excuse you from learning traditional CPR skills – as they will enable you to assist in a wider range of cardiovascular and respiratory emergencies – it is comforting to know that “something is better than nothing” and defaulting to this new simplified version just might save a life. As my first CPR instructor used to say, “CPR is like horseshoes and hand grenades – close counts.”

More information, including an extensive list of FAQ’s can be found at www.americanheart.org/handsonlycpr.

Dr. Thomas R. Lamar is a chiropractor at Anchor Chiropractic in the Health Services Center and holds a postgraduate certification as a Chiropractic Extremities Practitioner. He invites questions and comments. Send to 25989 Barber Cut Off Road NE, Kingston, WA 98346 or telephone (360) 297-8111.

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