Current recommendations for cardiopulmonary resuscitation (CPR) have evolved, particularly regarding mouth-to-mouth breathing. While once standard, the American Heart Association (AHA) no longer primarily recommends mouth-to-mouth for untrained bystanders responding to most adult sudden cardiac arrests.
Current Recommendations for Lay Rescuers
For adults experiencing sudden cardiac arrest, “hands-only CPR” is the primary recommendation for untrained bystanders. This method focuses on continuous, high-quality chest compressions. Rescuers should push hard and fast in the center of the chest, aiming for 100 to 120 compressions per minute. Each compression should be at least 2 inches deep, but no more than 2.4 inches. This approach makes CPR more accessible and effective for many lay rescuers.
When Rescue Breaths Are Still Vital
Despite the shift towards hands-only CPR for adult cardiac arrests, rescue breaths remain important in specific situations. These include cases where the cause of cardiac arrest is respiratory, such as drowning, drug overdose, or suffocation, and in instances involving infants and children. In these scenarios, oxygen levels are often severely depleted, and rescue breaths significantly improve survival. Trained professionals typically perform conventional CPR, combining chest compressions with rescue breaths at a ratio of 30 compressions to 2 breaths.
Why CPR Guidelines Have Changed
The evolution of CPR guidelines, emphasizing hands-only CPR for lay rescuers, stems from several factors. Studies showed bystanders were less likely to initiate CPR if it involved mouth-to-mouth contact, due to concerns about disease transmission or lack of confidence. Research also demonstrated that in many adult cardiac arrests, blood contains sufficient oxygen for the first few minutes, making immediate, continuous chest compressions most important for circulating oxygenated blood to vital organs. Prioritizing compressions minimizes interruptions, which negatively impacts blood flow. This approach makes CPR easier to remember and perform, encouraging more people to act.
What to Do in a Cardiac Emergency
In a cardiac emergency, immediate action is necessary. First, call emergency medical services, such as 911. If an adult suddenly collapses and is unresponsive, begin chest compressions without delay. If an automated external defibrillator (AED) is available, locate it and follow its voice prompts, as using an AED can significantly increase survival rates. Continue chest compressions until emergency responders arrive or the person shows signs of movement.