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Hands-Only CPR: The How, Why, and Does it Work?

By Clif Castleman, WEMT & American Red Cross Instructor

My thoughts as a medical professional (and by the way, these protocols have already become effective in Loudoun County, Virginia), are that overall, it makes sense, however you’re only supposed to provide chest compressions for the first two minutes after arriving on the scene where somebody has collapsed and¬†you witnessed them collapse¬†then switch over to providing “traditional” CPR. The order of things is a bit of a lie; because first things first, you still have to check the scene for safety, then check the victim to see if they’re responsive; if so, call 9-1-1 or your local emergency response number. Only then should you begin to do chest compressions.

After two minutes of chest-compressions-only have been done, both the American Heart Association and American Red Cross state that you then need to go into “traditional” CPR with 30 chest compressions and two breaths. This is because there is enough residual oxygen in your bloodstream and vital organs, however after roughly two minutes, that residual oxygen is used up, and must be replaced with new fresh oxygen. Remember, the air we breathe contains roughly 21% oxygen and when we breathe it in, our body uses only about 5% of that, exhaling 16% oxygen – which is way more than enough for another human being to utilize.

The real key to all of this is the Automated External Defibrillator, or AED. The AED is designed to shock the heart back into an effective rhythm. The sooner an AED is brought to the aide of a person who has collapsed and is completely unresponsive – even to painful stimuli such as a sternal “noogie” or a hard pinch on the back of their arm – the better chance that person has of being successfully revived. If you find yourself in a situation where you just saw the individual collapse, have checked for scene safety, checked them for responsiveness, and have called 9-1-1 – and there’s an AED in the building but no one else to go get it, GO GET THE AED FIRST and don’t worry about the two minutes of compressions, because literally speaking, the chest compressions are only pumping somewhat oxygenated blood to the vital organs long enough for an AED to restart the heart on its own.


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