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Sunday, June 2, 2013

Tools made of the element 'Unobtainium'

It's easy to forget that CPR guidelines have been changing. And with each change, they have been placing an increasing burden on the rescuer.

Does anyone remember how many CPR instructors failed to re-qualify when the '2005' Guidelines kicked in? it was the burden of demonstrating that they could perform five full cycles of 30 & 2 that they couldn't handle. That's two minutes of 1.5 to 2 inch compressions! - less demanding than today's "two inches or more."

The Tomlinson et al. data clearly shows the non-linear nature of the relationship between force applied and depth attained: compressing a chest twice as deeply takes more than twice the force. The data from the Netherlands, from Norway, and from a major US city [data has not yet been published] all show that even if we're only talking about 95% of the human chests, you have to be able to apply a force of more than 80kg (176 lb) to compress all the chests by two inches. (The lower end of the data is 18kg (40 lb), but that's not where the problem lies.)

If you are the only one there when someone else arrests, you're going to have to perform compressions for an average of ten minutes. Most people who are likely to have to perform CPR on a human can't make it to four minutes, and some just aren't heavy enough to compress the relevant chest to guideline depth even once!

It's easy to assume that there will always be someone there to help you, but more than 2/3 of all cardiac arrests in the U.S.A. occur in the home, and 1/3 of all homes have exactly two adults in them.

...and don't even get me started on "Get the victim on his back on a hard, flat surface and compress the chest...." If we're talking about rescuers whose age is about the same as the victim, very few know how to get their spouse out of a recliner or out of bed.

It's wonderful that you took that CPR course last year, but when you reach your physical limit, here's something else to try.

Just click Movie or copy this URL and paste it into your browser:
http://youtu.be/-6yS9dwceHg

(The movie hasn't been optimized for YouTube, so there is some jerkyness in the playback, but you'll get the picture.)

Bob