Hands Only CPR: No Pulse (Check) Needed
A recent visitor to About.com First Aid had this to say about the Hands Only CPR Video:
This video on about.com gives wrong information. It says when a person stops breathing, give chest compressions. That is wrong. If the person's heart is still pumping, you do not do chest compressions -- you start rescue breathing.
This reader is correct that victims who are not breathing -- but still have a pulse -- would get artificial ventilation rather than CPR from a healthcare provider. Any EMT or paramedic would certainly check a pulse, but in layperson CPR the standard of care is to perform CPR on anyone who is not breathing -- no need to check a pulse. The idea is to simplify CPR for folks who rarely use it.
Checking a pulse on someone who may or may not have one is not as easy as it sounds. Even those of us who've been doing this for years get fooled into feeling pulses that aren't there or not feeling pulses that are there. It takes a bit of practice to be comfortable with a pulse check -- even if it seems simple.
Believe me, when these changes first came out, my colleagues and I were convinced that lay rescuers were going to be pushing on chests every time we arrived at the scene of a medical emergency, regardless what the emergency would be. If people didn't have to check pulses, we just knew they were going to be doing compressions willy nilly on every poor sap who had the bad fortune to fall asleep on a park bench.
However, that's not what happened. Instead, we found that folks are more likely to do CPR if the rules aren't hard to remember. They're not doing CPR all the time, but they are doing it, which is the whole point. Taking the pulse check out of CPR made it easier to perform and easier to learn. It is much less threatening to do now, which makes lay rescuers jump in and save lives.
Our video on About.com goes a step further than ditching the pulse check. It is not a video of traditional CPR, but of Hands Only CPR, the version endorsed by the American Heart Association and the American Red Cross for untrained rescuers. There are only two steps: call 911 and push on the chest. With Hands Only CPR there is no assessment step at all, let alone checking for a pulse.
I say it in the video and I'll say it again here: the most important thing if someone isn't responding is to do something about it. Call 911 and start pushing on the victim's chest, it may be all that's needed to save a life.
No pulse check necessary.
- Hands Only CPR Video
- How to Do Hands Only CPR
- How to Do Traditional Adult CPR
- Before You Take a CPR Class: What You Need to Know
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Comments
As an RN I too was originally shocked by the new guidelines from the AHA. In retrospect, however, it makes perfect sense. Even after years of CPR and Advanced Life Support (ACLS) classes it was difficult for even the best of us to remember what the ventilation to compression ratios were for every situation. New research suggests that we were hyperventilating and not doing enough compressions to circulate that oxygen.
Even worse was that lay people were too afraid they would mess up the ratios to attempt CPR.
The new guidelines which suggest fewer pulse checks, (or none at all for none medically trained personnel), emphasize the most important and simple components of CPR: push hard and push fast. Our ACLS teachers have taken to playing the song “Staying Alive” while we practice chest compressions because the beat is just the right rate to provide 100 chest compressions per minute.