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Commercial Fisheries News
Volume 35 Number 11
July 2008
CPR: New approach saves more lives
According to data collected by the US Coast Guard, there were 12 fatal heart attacks among fishermen in the First District between 1993 and March 2008. In fact, fatal heart attacks were the fourth most common cause of death after sinking, man overboard, and capsize during that 15-year period.
Those of us who were trained in cardiopulmonary resuscitation (CPR) before Dec. 13, 2005 learned about jaw thrust and the 15 chest compressions to two breaths rule and practiced checking the pulse between cycles of chest compressions.
These practices are no longer recommended.
Instead, the American Heart Association is promoting new, easier procedures that are described in the association’s 2005 “Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.”
The information for this article was gathered from the quarterly newsletter Currents in Cardiovascular Care, Winter 2005-2006 edition, and through a discussion with Michelle Drolet, preparedness director at the Manchester, NH office of the American Red Cross.
Simplify, simplify
Studies show that people who survive a sudden cardiac arrest received “early, high-quality CPR.”
The new CPR procedures were developed to increase survival rates and to make CPR easy for everyone to remember and administer.
Now there is a single compression-to-ventilation/rescue breath ratio of 30 chest compressions to two rescue breaths or 30:2. The emphasis of the revised procedures is on maintaining the circulation of blood to vital organs such as the heart, lung, brain, and kidneys.
New procedure
The following procedures assume that a cardiac arrest has happened in front of a lay rescuer, meaning someone without formal emergency medical training.
1. Spend less than 10 seconds checking to see if breathing is normal. Gasping is not normal breathing. If breathing is not normal, get started quickly with CPR to help send blood throughout the body.
2. First check the airway. If blocked, tilt the head and lift the chin to open the airway. The jaw thrust is no longer used. Use abdominal thrusts to clear the obstruction – a foreign body or water – from the airway.
3. Then give two rescue breaths of one second each. Begin by breathing in normally yourself. Do not take a deep breath because delivery of too much air can actually hinder circulation. If the chest does not rise with your breaths, the airway is blocked so go back to step 2.
4. Immediately begin “push hard-push fast” compressions with the palms of your hands on the breastbone at the level of the nipples for an adult or child. The compression rate should be about 100 compressions per minute or basically close to two compressions per second.
5. Give 30 compressions and then two rescue breaths of one second each – 30:2.
6. Keep the 30:2 compression-to-ventilation cycle going until the victim is responsive or professional help arrives. Do not interrupt the cycle. The goal is to keep blood circulating. An interruption in the compressions causes the blood to stop flowing.
Additional considerations
Victims of drowning and others with severe airway obstruction will not respond to CPR unless the water or obstruction is removed. Clear the water or obstruction with shoulder blade level slaps followed by abdominal thrusts if needed before beginning CPR.
In a man-overboard situation, if the victim goes into cardiac arrest while hypothermic, meaning very cold, begin CPR but try to remove wet clothing and wrap the victim in blankets.
If you have an AED – automated external defibrillator – on board and have been trained to use it, give one shock followed by immediate CPR beginning with chest compressions.
Keep blood moving
The major goal of the revised CPR procedure is to keep the blood moving so it can transport what oxygen is in the victim’s system to the rest of the body. All elements of the procedure are tied to this idea.
The compression-to-ventilation/breaths ratio of 30:2 is useful for all ages (except newborns) and is easier to remember and administer than the pre-2005 procedure.
For more information, contact your local chapter of the American Heart Association or American Red Cross. Michelle Drolet is happy to answer questions about the new CPR guidelines. Call her at (603) 624-4307 or e-mail her at <droletcm@usa.redcross.org>.
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