Last updated: March 24, 2021
An ACLS Guide to Hands Only CPR
An ACLS Guide to Hands Only CPR
As of 2008, the use of hands-only cardiopulmonary resuscitation (CPR) became the best practice when attempting to revive victims of cardiac arrest. This is a change from the previous guidelines, which support the use of both chest compression and mouth-to-mouth ventilation.
Hands-Only CPR does not eliminate the need for conventional CPR. Based on three major studies and the agreement from the American Heart Association’s Emergency Cardiovascular Care Committee, the hands-only method works just as well when performed on adults.
Hands-only CPR is beneficial in helping to resolve any unease that untrained bystanders may have about performing CPR due to health concerns regarding mouth-to-mouth ventilation. An increase in bystander participation in cases of cardiac arrest may help to improve the victim’s chances of survival.
When to implement hands-only CPR
Implement hands-only CPR when an adult suddenly collapses and is unresponsive.
There are two basic steps to remember, which makes this method a better option for people who are uncomfortable with, or untrained in, conventional CPR methods.
Upon seeing the victim collapse, 911 should immediately be notified either by the person who is preparing to perform CPR or if there are other people nearby, one of them should be instructed to make the call; this saves the CPR provider valuable time.
Immediately after placing the call, firm chest compressions should be started at a rate of 100 beats per minute until emergency personnel arrives. There is no need for mouth-to-mouth ventilation at this time unless the victim needs resuscitation due to drowning, carbon monoxide poisoning, or some other incident that involves a lack of oxygen before the collapse.
Note: When performing the traditional method of CPR, there must be 30 chest compressions made at a rate of 100 per minute for every two breaths given to the victim.
Cardiac arrest versus heart attack
The term cardiac arrest throws some people off—it is often used interchangeably with heart attack, but they are two different scenarios.
Heart attacks usually occur because a block in an artery prevents blood rich oxygen from reaching the heart. Classic symptoms include: gripping, heavy chest pain that may often spread to the jaw, either arm, or the back; difficulty breathing; nausea; or fatigue.
Cardiac arrest is when the normal heartbeat is interrupted. The lower chambers of the heart, the ventricles, chaotically quiver (ventricular fibrillation), race (ventricular tachycardia), or may stop pumping altogether—blood then stops circulating. During a cardiac arrest, the victim will suddenly collapse and lose consciousness—the brain is not getting the blood it needs. Other systems, such as the respiratory system, quickly shut down.
The confusion about the difference between cardiac arrest and heart attack is that a heart attack is a common trigger of cardiac arrest. People with “clean” coronary arteries are victims of cardiac arrest as well, for various reasons, including defects in the systems that pump the heart.
Approximately every year, 300,000 Americans suffer cardiac arrest outside of a hospital. Cardiac arrest is often dramatized as occurring in a public place; however, 80% of the time people are in a residential setting or at home. Some stereotypes ring some factuality: a prototypical victim is a man in his 50s or 60s.
Statistics: Hands-only CPR
It is estimated that 94% of people suffering from sudden cardiac arrest die before reaching the hospital. Part of this because only 24% of these victims received any type of CPR from bystanders upon collapse.
The chance of survival when hands-only CPR is given doubles and may even triple if delivered in a timely fashion.
Hands-only CPR is more efficient than conventional CPR for people in whom out-of-hospital cardiac arrest is observed and shocked with public-access automated external defibrillator (AED).
When it came to the patients that were given conventional CPR, only 7.8% survived; this was, however, still better than the 5.2% survival rate of those who did not receive any form of CPR.
Chest-compression-only CPR (CCO-CPR): https://www.ncbi.nlm.nih.gov/pubmed/23230315
Chest compression-only CPR: A meta-analysis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987687/
Bystander-initiated chest compression-only CPR is better than standard CPR in out-of-hospital cardiac arrest: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484593/
What is a heart attack: https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack
What is sudden cardiac arrest: https://www.nhlbi.nih.gov/health/health-topics/topics/scda
The circulatory system: https://scribeschool.net/circulatory-system-info-for-scribes.html