Compression only CPR has been discussed and bantied about for several years now but we are raping up to that next set of updates from the cardiac symposium, the American Heart Association and others who will come up with the next round of recommendations for what CPR should be. For bystanders, some places have started moving towards compression only CPR. 911 centers are often now promoting compression only CPR when they educate bystanders over the phone on how to perform CPR in the field before rescuers arrive.
What does this really mean for us in the health care arena? Is this is going to change the way we perform CPR? I doubt it, I think that we will not be moving away from supporting and managing an open airway and supporting an appropriately providing ventilations for our patients and I have to conditionally say that because that appropriate ventilations seem to be the source of some of the issues for the health care arena. For bystanders,a lot of them don’t want to do mouth to mouth ventilations on their patients and rather than trying to educate patients and educate bystanders about that over a phone call in 911 or dealing with the fact that they just aren’t going to do anything, bystander CPR with compressions only is probably a good thing rather than have no CPR at all.
Numerous studies seem to bare this out that there is a significant difference between CPR performed with ventilations versus CPR by bystanders performed without ventilations and so that’s where those recommendations come from from the several studies both in the United States and the other parts of the world. What does this mean for health care providers? We’re still going to be providing and managing airways and expected to do so. We need to understand some of the physiological reasons why we need to manage an airway appropriately, not over ventilate our patients, we need to maintain that negative chest pressure gradient within the thoracic cavity to facilitate return of blood flow to the heart but we need to provide oxygen to our patients as well. So we’re going to be probably still continuing to ventilate our patients and as this article pointed out, there is no change for pediatric patients. Pediatric patients often are in cardiac arrest because of an airway issue, they have choked on something, they have somehow stopped breathing and so their problem is related to a problem with their oxygenation and airway management is going to be key to getting cardiac arrest reversed if possible. So we need to of course apply our medical knowledge to what’s going on with these patients and that’s why I don’t suspect there’s going to be any difference or major changes for the way we perform CPR. We may have a larger compression to ventilation ratio, I think it might go up to 50 to 2 and so be expecting an increase in that regard but I don’t think we’re going to see compression only CPR coming into the hospital space or the health care provider space anytime soon. But I wanted to point this out to you,t his is an article that is- we’re likely to see more articles like this as time nears for the updates. I think later this year, we’re going to have that meeting and the American Heart Association will come out with a response and recommendation for the next round of what CPR classes are gonna look like, so be prepared for that but I wanted to provide this update to you.
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This article has been featured in the news segment of the Nursing Show episode Johnson & Johnson’s Campaign for Nursing’s Future and Episode 143
