Form and Function

There was quite a bit of attention paid to CPR in 2005 when the American Heart Association announced that CPR using chest compressions only had been shown to be as beneficial as chest compressions plus rescue breaths. My first CPR recertification since the announcement was earlier this year, and although the press had widely reported that the breaths were being eliminated from CPR training, that turned out to be untrue. (Side note: I took the class at PVH with mostly PVH staff, and there was one NICU nurse in the class who had never once taken CPR or neonatal resuscitation in her 20 year career. How does that happen?)

We learned both the chest compressions and rescue breaths, although at a higher compression:breath ratio than in years past. The instructor explained that they'd found that some potential rescuers did not want to perform mouth to mouth breathing on a stranger and were therefore doing nothing. For those victims who's collapse or accident is witnessed (i.e. it is known immediately rather than discovered after an unknown amount of time) and who can receive professional emergency care within only a few minutes, compression-only resuscitation is as effective as compressions plus breaths. Anyone who has been down an unknown amount of time or will experience a time delay before paramedics arrive must receive breaths to oxygenate the blood. Most resources suggest 4 minutes is the time frame in which the brain can survive on oxygen already in the blood, but the world record for breath holding is 8 minutes plus, so I suppose 4-8 minutes from collapse to EMS care is an approximate range of time in which compression-only CPR can be effective.