Compression Only CPR Confusing to Many, Red Cross Says

Compression only CPR is not to be used for prolonged periods of time. It is also not recommended for children or victims of breathing emergencies.

Photo of compression CPR courtesy: howstuffworks.com

(SALEM, Ore.) - Recent media coverage of "Compression Only CPR" has prompted concerned citizens to ask for clarification on this life-saving topic from volunteers and staff at the Willamette Chapter American Red Cross.

"Our phones are ringing, we are talking at business meetings, public forums and of course in our first aid and CPR classes throughout Marion and Polk counties", said Jennifer McCormick, health and safety director of the chapter.

This is not a new topic for the American Red Cross. For several years compression only CPR has been taught to be used only when a bystander has witnessed the sudden collapse of an adult, has called 911 for help and is unwilling, untrained or unable to perform full CPR (cycles of 30 chest compressions and 2 rescue breaths).

Compression only CPR is not to be used for prolonged periods of time. It is also not recommended for children or victims of breathing emergencies. There is no substantial clinical evidence to support claims that compression-only CPR should replace full CPR. A trained responder should perform the skills the same way they were taught in their CPR certification training, unless they are unable or unwilling to perform full CPR.

"People are confused about this topic, and that is understandable", said McCormick. "We are answering a lot of questions, and we welcome the opportunity to discuss this important issue, but the answer is sometimes more involved than people will tolerate in a quick phone call." The Red Cross offers a full range of classes in varying levels of emergency response and encourages everyone to be informed on saving lives. Those interested may call 503-585-5414 or visit redcross-salem.org. Additional questions and answers are included below.

Compression-Only CPR Frequently Asked Questions

Q. What is Compression-Only CPR?

A. Compression-Only CPR is giving continuous chest compressions (approximately 100 compressions per minute) without giving rescue breaths.

Q. When should Compression-Only CPR be used?

A. Based on scientific evidence, the American Red Cross supports Compression-Only CPR (continuous chest compressions) as an effective alternative when:

* a bystander is unwilling, unable, untrained or unsure how to perform full CPR (cycles of chest compressions and rescue breaths) and;

* a bystander has witnessed the sudden collapse of an adult.

Q. When should Compression-Only CPR not be used?

A. Compression-Only CPR should not be used for infants and children, for an adult whose sudden collapse is not witnessed or when a respiratory emergency may have caused the cardiac arrest.

Q. Is "Compression-Only CPR" the same as "Hands-Only CPR?"

A. Yes. The Red Cross uses the term "Compression-Only CPR" while the American Heart Association (AHA) uses “Hands-Only CPR.” The technique is the same – giving continuous chest compressions (approximately 100 compressions per minute) without giving rescue breaths.

Q. Do the Red Cross and AHA agree on the recommendations for Compression-Only CPR?

A. Yes. Both Red Cross and AHA hope that Compression-Only CPR will save lives by encouraging bystanders who witness the sudden collapse of an adult to get involved and have someone call 9-1-1 or the local emergency number and then start giving continuous chest compressions until help arrives or the adult shows obvious signs of life (normal breathing or movement).

Q. Do people still need to take traditional CPR courses?

A. The Red Cross encourages everyone to learn traditional or full CPR (cycles of chest compressions and rescue breaths). There are emergency situations where a person shows no signs of life (normal breathing or movement) and may benefit from full CPR. Many individuals will still need to take training that includes full CPR such as those who take CPR training for certification to meet federal, state and local requirements, lay responders in workplaces who have a duty to respond, or those who care for infants and children.

Q. What about professional rescuers?

A. Compression-Only CPR does not affect Red Cross professional rescuer level CPR/AED training programs.

Q. Do you use an AED if performing Compression-Only CPR?

A. Yes. An automated external defibrillator (AED) should be used as soon as it becomes available – regardless of whether or not the sudden collapse was witnessed. The device will not cause additional harm to the victim and will not defibrillate unless a shockable rhythm is detected.

Q. What should I do if I am trained in full CPR, do not have a duty to respond and witness the sudden collapse of an adult?

A. If you are trained in full CPR, do not have a duty to respond and you witness the sudden collapse of an adult - have someone call 9-1-1 or the local emergency number. If you are comfortable doing so, give full CPR. If you are not comfortable do so, giving Compression Only CPR is an effective alternative. Continue compressions until help arrives or the adult shows obvious signs of life (normal breathing or movement).

Q. What should I do if I am trained in full CPR, have a duty to respond and witness the sudden collapse of an adult?

A. If you are trained in full CPR, have a duty to respond and you witness the sudden collapse of an adult - have someone call 9-1-1 or the local emergency number. Perform the skills according to your level of training.

Q. Should Compression-Only CPR be taught in Red Cross certified lay responder and professional rescuer courses?

A. No. Compression-Only CPR does not affect the curricula or skills in current Red Cross certified lay responder or professional rescuer level courses. The topic may come up in class and instructors should use these "FAQs" plus the "Instructor’s Note" (p.100) and the "FAQ" (p.110) in the First Aid/CPR/AED for the Workplace, Schools and the Community Instructor’s Manual to address questions.

Q. Can we offer Compression-Only CPR presentations?

A. Yes. In the summer of 2007, the Red Cross introduced First Aid and CPR for Everyone, an at-home kit for practicing Compression-Only CPR. The kit contains information on proper hand placement on the chest and a compression practice tool to help measure just the right amount of pressure needed to properly administer chest compressions. Chapters may sell the First Aid and CPR for Everyone kits and use the DVD and guide to demonstrate Compression-Only CPR during presentations to the general public. Due to the potential confusion for employers between first aid and CPR/AED certificates and “has attended” certificates, no certificates should be issued to those attending Compression-Only CPR presentations.

The Willamette Chapter is beginning its 92nd year of service in Marion and Polk counties.

An 8-minute video about the work of the local Red Cross can be viewed on the chapter’s website redcross-salem.org.