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Order of CPR steps among recommended changes

November 16, 2010
By GARRETT NEESE Houghton Daily Mining Gaazette

HOUGHTON - The American Heart Association's new cardiopulmonary resuscitation standards are taking effect Jan. 1, including a change in the sequence of steps.

Chest compressions are now the first step in CPR, which changes from A-B-C (airway, breathing, compressions) to C-A-B (compressions, airway, breathing).

Portage Health wellness coordinator Joni Rozich said anyone certified in a CPR course should wait until their certification expires before becoming recertified; it will still be valid.

Article Photos

Employees of Superior Smiles in Hancock undergo cardiopulmonary resuscitation standards training recently. The American Health Association is instituting new CPR standards starting Jan. 1, including making chest compression the first step. (Houghton Daily Mining Gazette photo by Garrett Neese)

"The life-saving techniques we're using right now are still very good to use," she said. Rozich also said during this changeover period, CPR teams should communicate to make sure they're using the same technique.

The Portage Health Training Center trains about 1,300 people each year, Rozich said. Over the next month and a half, training instructors will learn the new guidelines and receive new materials.

While Rozich admits some people may find it annoying to learn new procedures, she said it's a positive development.

"I think it's pretty exciting, because the more we learn, and the better lifesaving techniques we use, the higher the success rate," she said.

The new techniques apply to adults, children and infants; newborns are excluded.

CPR was first introduced in 1960; the first AHA guidelines came out in 1966. If CPR is performed immediately after cardiac arrest, it can double or triple the likelihood of survival.

Every five years, hundreds of resuscitation experts from the AHA and other organizations make revisions to CPR guidelines based on new research. That was the case with moving compression to the leadoff spot, as researchers found those who started CPR by opening the airway took 30 seconds longer to begin chest compressions.

"This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating throughout the body," guidelines co-author Michael Sayre said in a statement. "Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compression right away."

Advanced Cardiac Life Support and Heart Saver standards will be released in April, followed by Pediatric Advanced Life Support standards in July.

Other new developments in the AHA guidelines:

- chest compressions should be sped at least 100 per minute (as the AHA helpfully notes, the same speed as the Bee Gees' "Stayin' Alive").

- those compressions should be deeper - at least 2 inches in adults and children and one-and-a-half inches in infants.

- rescuers should avoid leaning on the victim's chest between compressions, which would prevent it from returning to the starting position.

- 9-1-1 centers should provide instructions over the phone to start chest compressions if cardiac arrest is suspected.

The AHA also recommends that untrained bystanders use hands-only CPR, in which they call 911 and push hard and fast on the center of the chest until professional help or an automated external defibrillator arrives.



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