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Heart Association Pumps up Bystander CPR

DUBUQUE, Iowa -- Bystanders performing chest compression on cardiac-arrest victims could save more lives than they harm. That's the conclusion of an American Heart Association scientific statement published in the journal "Circulation." Cardiac arrest occurs when the heart completely stops pumping.

Chest compression can help manually pump blood to the organs that need it most during that time of crisis -- including the brain. However, people who lack CPR training but encounter someone who needs it are often afraid to act. Wouldn't their unskilled efforts cause more harm than good?

"People ask that in the classes we teach," said Amy Cherne, clinical nurse specialist for critical care and cardiac services at Mercy Medical Center-Dubuque. "They could be hurting the person more by not doing anything for them."

The American Heart Association makes four recommendations for EMS personnel and 911 dispatchers:

  • Dispatchers should assess whether someone has had a cardiac arrest and if so, tell callers how to administer CPR immediately.
  • Dispatchers should confidently give hands-only CPR instructions for adults who have had a cardiac arrest not caused by asphyxia (as in drowning).
  • Communities should measure performance of dispatchers and local EMS agencies, including how long it takes until CPR is begun.
  • Performance measurements should be part of a quality assurance program involving the entire emergency response system including EMS and hospitals.

"Bystander CPR is clearly linked to improved cardiac-arrest survival rates, but only 25 to 35 percent of all cardiac arrest patients get bystander CPR in most places," said Dr. Ben Bobrow, co-author of the American Heart Association study and the medical director of the Arizona Department of Health Services' bureau of EMS & Trauma System.

Bobrow said that some localities already have implemented the association's recommendations.

"Places like Seattle that have far higher bystander CPR also have higher survival rates," he said. Cherne said bystanders need not worry about perfect technique. "If you push hard and push fast, you're doing really well," she said.

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