NEW CPR & POLST

THE NEW CPR GUIDELINES!

SKIP THE MOUTH TO MOUTH

You can skip the mouth-to-mouth breathing and just press on the chest to save a life.

In a major change, the American Heart Association said that 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 jump in and help if they see someone suddenly 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 Dr. Michael Sayre, an emergency professor at Ohio State University who headed the committee that 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 having cardiac arrest — the heart suddenly stops — which can occur after a heart attack or be caused by other heart problems. In such a case, the victim still has ample air in the lungs and blood and compressions keep blood flowing to the brain, heart and other organs.

A child who collapses is more likely to primarily have breathing problems — and in that case, mouth-to-mouth breathing should be used. That also applies to adults who suffer lack of oxygen from a near-drowning, drug overdose, or carbon monoxide poisoning. In these cases, people need mouth-to-mouth to get air into their lungs and bloodstream.

'Better than nothing'

But in either case, “Something is better than nothing,” Sayre said.

The CPR guidelines 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.

Now the heart association has given equal standing to hands-only CPR. Those who have been trained in traditional cardiopulmonary resuscitation can still opt to use it. Hands-only CPRThe American Heart Association says bystanders who witness an adult's* sudden cardiac arrest can opt to perform hands-only CPR and skip mouth-to-mouth breathing. If someone collapses, stops normal breathing and is unresponsive to shaking: First, have someone call 911, or call yourself.

Put the victim on the floor, face up.

Put one hand on top of the other in the middle of the victim's chest.

Push hard and fast, 100 presses a minute.

If there's another bystander, take turns.

Continue until paramedics take over.

Use an automated external defibrillator if available.

* Children and drowning victims still need mouth-to-mouth.

Source: University of Arizona Sarver Heart Center

Sayre said the association took the unusual step of making the changes now — the next update wasn’t due until 2010 — because three studies last year showed hands-only was as good as traditional CPR. Hands-only will be added to CPR training.

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 hands-only CPR while awaiting medical treatment have double or triple the chance of surviving. But less than a third of victims get this essential help.

Dr. Gordon Ewy, who’s been pushing for hands-only CPR for 15 years, said he was “dancing in the streets” over the heart association’s change even though he doesn’t think it goes far enough.

Dr. Ewy is director of the University of Arizona Sarver Heart Center in Tucson, where the compression-only technique was pioneered.

Ewy said there’s no point to giving early breaths in the case of sudden cardiac arrest, and it takes too long to stop compressions to give two breaths — 16 seconds for the average person. He noted that victims often gasp periodically anyway, drawing in a little air on their own.

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

“When people are honest, they’re not going to do it,” he said. “It’s not only the yuck factor.”

In recent years, emergency service dispatchers have been coaching callers in hands-only CPR rather than telling them how to alternate breaths and compressions.

POLST: The Physician Orders for Life-Sustaining Treatment (POLST)

This program is designed to improve the quality of care people receive at the end of life.

It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored PINK form and a promise by health care professionals to honor these wishes.

The POLST form needs to be signed by you and your personal physician.

There is a POLST Paradigm Program in Monterey County. The next class is 11/14/09 at the Carmel Foundation.

Email: SusanBradley01@comcast.net for more details.

What type of care would you want if you only had one week to live?

Most people say that they want to be:

1. Pain-free

2. Have Family& Friends around them.

3. Want Spiritual Care.

What other requests do you have?

Make sure your friends and family know your desires.

Would you want music playing?

If so, then what type?

What most people don't know is that at the end stages of life when you are in a Hospice situation can decrease the discomfort you or your loved one might feel.

As a former Hospice Nurse for the VNA the biggest mistake that family members make is NOT giving enough medications to their loved one. Ativan and pain relievers will improve the quality of your loved ones last days of life. You do not have to worry about you or your loved one becoming addicted to pain relievers.

Having a POLST form signed and ready to go in case you ever need it will help your loved ones make better decisions based on what you want.

Let us know if you want copies of the forms emailed to you.