Cardiac arrest remains a major concern for all people. As explained by the National Heart, Lung and Blood Institute, cardiac arrest occurs when the heart suddenly stops beating. Depending on each person, this may be the culmination of multiple health and medical problems, or it may occur following a trauma. Other causes of cardiac arrest include arrhythmias, a heart attack and heart disease. Unfortunately, most cardiac arrests, approximately 350,000, reports CPR.Heart.Org, occur in environments away from health facilities. These cases are also known as out-of-hospital cardiac arrest and without immediate intervention, such as traditional CPR, and hands only CPR and defibrillation, mortality risk increases.
Failure to receive care in a timely manner will lead to negative outcomes, including permanent injury and loss of quality of life. To save lives, it is important to understand the value of providing immediate care for encouraging skills that even untrained individuals may use an emergency.
The Shocking Prevalence of Cardiac Arrest and Bystander CPR
Cardiac arrest rates vary widely by reporting year. For example, out-of-hospital cardiac arrest rates in 2014 were among the highest in recent history, sitting at 424,000. While the prevalence has declined slightly, the stark figures suggest awareness campaigns for CPR and life-saving support, such as the skills gained in this course, available here, have made an impact.
The bystander CPR rate for 2016 out-of-hospital cardiac arrests was 46.1%. Even though bystander CPR rates have risen, a mere 12% of those that suffer out-of-hospital cardiac arrest survived. However, that figure has risen 2.5% since 2013.
Causes of CPR depend on each person, but ventricular fibrillation remains the most common cause of cardiac arrest. Defibrillation with an automated external defibrillator (AED) and treatment of the cause of the arrhythmia is essential to survival. Meanwhile, hypertension, myocardial infarction (MI), more commonly known as a heart attack, may also contribute to arrest. Physical stress on those with undiagnosed cardiac problems may lead to arrest as well. Until medical help arrives, those in the immediate vicinity must bear the responsibility of both passerby and first responder.
Taking all that into consideration, survival rates have increased. Clearly, receiving CPR outside of the hospital made a difference. Yet, many people continue to forgo something into action for fear of failure to perform CPR properly. This is where the use of hands-only CPR proves most valuable.
Why Hands-Only CPR Saves Lives
Common Questions About Hands-Only CPR
Hands-only CPR refers to the physical action performing CPR with only chest compressions. In other words, it is unnecessary to switch between performing chest compressions and administering rescue breaths. This alleviates the risk of tissue death and oxygen deprivation when taking too long to administer such breaths.
Does Hands-Only Care Really Work to Help People Survive?
Health agencies recommend the use of hands-only care in out-of-hospital circumstances. The practice focuses on maintaining blood flow to the vital organs and brain. As explained by the CDC.Gov, more than 50% of those that suffer an out-of-hospital arrest suffer injury to the brain and permanent injuries that decrease life span. Maintaining circulation through hands-only care lowers risk of long-term injury. Multiple studies have found strong results that support the use of hands-only care in out-of-hospital situations, says HealthSafety.com. Combined with the historic incidence of operator-guided CPR through a phone, risk of failure in performing traditional CPR increases dramatically. Instead of wasting time, people can save lives with the hands only option.
Does Hands-Only CPR Require a Certain Compression Rate?
A simple awareness campaign CPR poster for hands-only intervention will emphasize its ease of use. For instance, CPR ventilation-to-compression ratios changed multiple times over the years. While the compression rates have been streamlined to 100 compressions per minute, people may still hesitate. Instead of focusing on a rate, hands-only care relies on instinct, encouraging responders to push hard and fast in the center of the chest.
Of course, with the recent revision to the rate of compressions, as noted in a past post, available here, a common song may even be a helpful tool for those administering hands-only care.
The Bee Gees song, “Stayin’ Alive” is set to a rhythm of 100 beats per minute. If a person performing hands-only care pushes into the victim’s chest with the beat, the rhythm is correct. However, failure to know the song does not affect the recommendation for hands-only care. Instead, rescuers simply go fast and hard to help with staying alive as the song implies.
Can I Practice Hands-Only Care or Attend a Class?
Yes, you can practice hands-only care by pushing against a homemade CPR manikin. A prior blog, published here, provides detailed instructions on how to make a CPR manikin with a t-shirt, a 2-liter plastic bottle and newspaper.
Practicing hands-only care is simple. Push hard and fast in the center of the manikin, just below the base of the bottle. Practicing on a homemade manikin also helps you learn how to allow for proper chest recoil.
While allowing for chest recoil is a component found in traditional CPR courses, giving the chest a chance to rebound improves blood flow. As a result, morality and permanent injury risk decrease. Of course, following the tips and notes in that past blog can also help you learn how to perform basic CPR steps, such as opening the airway and delivering rescue breaths. Yet, these additional steps take time, and if you have any doubt, it is best to simply perform hands-only care.
Do I Need to Know How to Check a Pulse to Perform Hands-Only CPR?
No. Hands-only CPR was designed for those with limited if any, medical training. Health professionals realize that time is of the essence, so they do not spend more than five seconds checking for a pulse. Meanwhile, passersby may take extra time in searching for a pulse before initiating CPR. With the hands only option, the need to check for a pulse is eliminated. Even those that are choking who lose consciousness can benefit from hands-only care. Remember if someone is choking and loses consciousness, First Aid dictates that the person receives chest compressions to dislodge the blockage from the airway.
Can I Perform Hands-Only CPR on Infants and Small Children
Hands-only CPR is a universal way to ensure circulation for those entering cardiac arrest outside of the hospital. In children and infants, chance favors a trauma as a cause for cardiac arrest, not long-term health problems. Regardless of the injury, perform hands-only care on the child. However, infant hands-only care uses the index finger and the middle finger to perform compressions.
In any case, those responding to children in cardiac arrest have another option. They may carry the child while performing compressions. Being light-weight and smaller means that compressions can be performed safely while carrying the child to another person or care area. Obviously, if carrying the child to obtain aid would present an undue risk or hinder ability to provide compressions, stop and begin compressions immediately.
What About Pregnant Women and Obese Individuals?
Traditional CPR advises to move the hands further up on the chest when performing compressions. The same principle applies to the application of hands-only care. This technique will eliminate any concern over harming the baby, and in the case of obese individuals, it ensures adequate chest compression depth. The only concern among others when performing chest compressions safely involves the xiphoid process, a bone located at the base of the sternum (breastbone). Moving the placement of the hands upward avoids any risk for breaking that bone and causing further harm. Again, hands-only care wins and increases survival chances.
What Else Do I Need to Know?
The innovative hands-only approach to CPR does have a few key considerations that each bystander needs to know. Fortunately, they are simple and include:
- Hands only CPR is not a substitute for continued care under a health care professional. It is possible for a person to achieve a return of spontaneous circulation (ROSC) when performing hands-only care. Regardless of whether the person regains consciousness and circulation, always follow through with an evaluation at an appropriate emergency center.
- Contact emergency medical services (EMS) immediately when a person suffers cardiac arrest or other collapses. Although hands-only care aims to reduce delays in providing compressions, it does not replace the need to contact EMS. Always call EMS immediately, and if additional people are in the vicinity, ask them to make the call. This is the easiest and fastest way to begin compressions and save lives.
- Remember to check the scene for safety. Regardless of what occurred to precipitate cardiac arrest, performing hands-only care will do little good if the bystander suffers it too. Always check the scene for safety before attempting to render aid or perform compressions.
- Allow trained bystanders to take over and a render aid in CPR if available. While you could be the first person on the scene and begin performing chest compressions, anyone with a CPR Certification should take over the response when available. Traditional CPR is better than hands-only care, but to prevent loss of life, hands-only CPR is better than no CPR.
- If alone, scream and yell for help to get attention while performing compressions. This is especially true if you are unable to contact EMS on your own. Even in today’s world, phone batteries do lose their charge.
Knowing How to Perform Hands-Only CPR Will Definitely Help With Staying Alive and Thriving After Suffering a Cardiac Arrest
Statistically, every person will encounter someone that suffers cardiac arrest, and without the basic ability to perform hands-only care, that person has a greater chance of dying than living. Instead of risking life, work to save lives by knowing how to perform hands-only CPR at the least. Even without the benefits of medications and rescue breaths, fast and hard chest compressions can at least sustain a person until trained, professional medical responders arrive. Spread awareness of hands-only care; save lives by repeating that simple sentence. Push hard and fast in the center of the chest.
Have you ever seen anyone collapse without any rhyme or reason? If so, were bystanders concerned or worried about how to best care for the person, or did they intervene with hands only care? Unless trained individuals were nearby, that would have been the best option to increase the chances of survival. Spread awareness for the value of hands-only CPR for those without CPR training, and for anyone with a higher risk of encountering people in cardiac arrest, encourage enrollment in an accredited program, such as the online program, listed here. CPR, even hands-only CPR, does save lives and reduce the risk of permanent injury.