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New CPR Guidelines Emphasize Compressions First
Date:10/18/2010

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The experts also offer a new directive to trained rescue workers. People currently are trained to learn the ABCs of CPR -- which stand for airway, breathing and compressions. But the American Heart Association now suggests that the order should be CAB -- compressions first, then airway and breathing.

The idea is the same: Get blood and oxygen moving as quickly as possible.

The new guidelines also stress the need to push hard and fast when doing chest compressions, whether you're trained or not. The American Heart Association recommends that compressions be done to a depth of at least two inches and at a rate of at least 100 times a minute. It points out, however, that it's very important not to lean on the chest between compressions.

"Make sure you come all the way up because the heart fills with blood when you come off the chest," said Dr. Dana Peres Edelson, director of clinical research at the emergency resuscitation center at the University of Chicago Medical Center.

"It's physically challenging to compress a human chest," she said. "If you're doing it right, it will be tiring."

Some people worry that they'll hurt the person if they push too hard. But Sayre said that's seldom a real concern.

"Rescuers often don't push hard enough," he said. "But, people will happily trade a broken rib for being alive."

The new guidelines, published online Oct. 18 in Circulation, also encourage the use of hypothermia for people who've had cardiac arrest and are in a coma. "Cooling victims of cardiac arrest to about 92 degrees Fahrenheit for about a day seems to help reduce the amount of brain injury," Sayre said.

Peres Edelson agreed, saying that "hypothermia is widely underutilized but is one of the few things we have data for that we know can make a difference."

More information

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