Hands-only CPR is given a boost

NEW YORK - In a major change, the American Heart Association said yesterday that skipping the mouth-to-mouth and giving hands-only CPR - rapid, deep presses on the victim's chest until help arrives - works just as well as standard CPR for sudden cardiac arrest in adults.

Experts hope bystanders will now be more willing to help if they see someone collapse. Hands-only CPR is simpler and easier to remember and removes a big barrier for people skittish about the mouth-to-mouth breathing.

"You only have to do two things: Call 911 and push hard and fast on the middle of the person's chest," said Michael Sayre, an emergency-medicine professor at Ohio State University whose committee made the recommendation.

Hands-only CPR calls for uninterrupted chest presses - 100 a minute - until paramedics take over or an automated external defibrillator is available to restore a normal heart rhythm.

This action should be taken only for adults who unexpectedly collapse, stop breathing, and are unresponsive. The odds are that the person is in cardiac arrest - the heart suddenly stops - which can occur after a heart attack or as a result of other problems.

In such a case, experts now say, the victim still has ample oxygen in the lungs and blood; compressions alone keep blood flowing to the brain, heart and other organs.

A child who collapses is more likely to have mainly breathing problems. In that case, mouth-to-mouth breathing should be used. The same applies to adults who suffer lack of oxygen from a near-drowning, overdose, or carbon-monoxide poisoning. In these cases, people need mouth-to-mouth to get air into the lungs and blood.

The guidelines for cardiopulmonary resuscitation had been inching toward compression-only. The last update, in 2005, put more emphasis on chest pushes by alternating 30 presses with two quick breaths; those "unable or unwilling" to do the breaths could do presses alone.

The heart association took the unusual step of announcing equal standing for hands-only CPR now - the next update wasn't due until 2010 - because three studies last year showed it was just as good as traditional CPR.

An estimated 310,000 Americans die each year of cardiac arrest. Only about 6 percent of those who are stricken outside a hospital survive, although rates vary by location. People who quickly get CPR while awaiting medical treatment have double or triple the chance of surviving. But less than a third of victims get this essential help.

Anonymous surveys show people are reluctant to do mouth-to-mouth, partly because of fear of infections.

In recent years, emergency dispatchers have been coaching callers in hands-only CPR.

"They love it. It's less complicated and the outcomes are better," said Dallas emergency-medical services chief Paul Pepe.