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New technique for CPR training

CPR, cardiopulmonary resuscitation

A new simplified, easy-to-remember CPR technique is being promoted by St John.

The technique uses a ratio of 30 chest compressions to two breaths, irrespective of the patient's age and is being introduced into St John first aid courses in an attempt to make people feel more confident about performing CPR when caught up in an emergency situation.

As St John advisory group chair Tony Smith describes it, the aim is to get people to perform CPR when necessary without being hampered by concerns they might be doing too many chest compressions or not enough breaths. "People have been quite hung up on the detail that is not important... We want to move away from people being frightened to do something because they do not know the right way," Dr Smith says.

To keep it simple, the ratio has been changed to put the emphasis on chest compressions and to de-emphasise mouth-to-mouth. "Chest compressions are the most important aspect [of CPR] and we want to minimise interruptions," he says. Likewise, first aiders will be advised not to go hunting for a pulse before starting CPR on a collapsed person as this also causes a delay in initiating CPR.

The ratio of 30:2 is a compromise figure based on international guidelines and the number of compressions/breaths a person might be reasonably expected to perform and remember, Dr Smith says. He admits there's no doubt some people are put off attempting resuscitation because of mouth-to-mouth but, if so, they should at least try chest compression. And at the moment not many do try, with a person's chances of receiving CPR in the community declining each year. Currently, less than half of those who could benefit have received CPR prior to the arrival of an ambulance.

St John is hoping to improve those figures - in some countries it can be up to 75% - with another innovation in the new look courses - the Mini Anne manikin.

Developed in the US as part of a joint programme between the American Heart Association and manufacturers Laerdal Medical, Mini Anne has an inflatable chest and offers resistance of the chest during compressions.

St John is hoping the fact all first aid course attendees will receive a Mini Anne in a take-home kit might help improve those community CPR figures. Statistics show that for trainees using the Mini Anne, after 20 minutes, 20% were more likely to perform better overall CPR and 15% were more likely to have better hand placement compared to others using older training resources. What's more, after two months, 21% were more likely to perform better overall CPR and 24% were more likely to have better hand placement - evidence the take-home Mini Anne promoted further practice at home.

Four out of five went home and used the Mini Anne to teach family and friends.

Around 75,000 New Zealanders attended St John first-aid courses in 2005 and the agency would like to see a first aider in every household.

Key points

  • CPR is given when a person is unresponsive and there are no signs of life.
  • CPR is a mechanical means of externally supporting a person's breathing and circulation.
  • The aim is to circulate blood through the body, keeping the person's organs alive until ambulance or medical personnel arrive.
  • CPR requires 30 chest compressions followed by two (mouth-to-mouth) rescue breaths.
  • CPR may be needed on people who suffer a cardiac arrest, choking, drowning, electric shock, severe allergic reaction, severe trauma or prolonged shock.
  • There are around 3000 cardiac arrests cases each year in New Zealand, and about 5% survive.
  • Early CPR is one of several important factors in ensuring survival.
  • If you discover someone who is unconscious and has no signs of life (eg, not moving, not breathing), call 111 immediately, lay the person on their back and start CPR immediately.

This article was originally published in New Zealand Doctor newspaper. © UBM Medica (NZ) Ltd 2006

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