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Tuesday, January 19, 2016

Some things most bystanders don’t know about CPR…and why you need an AED in your home.

A heart attack is not the same thing as a cardiac arrest.  Heart attack victims normally are able to talk and many are in pain. Cardiac arrest victims are non-responsive, clinically dead, and are either not breathing normally – or they might be gasping.

CPR is not used on heart attack victims. CPR is only used on cardiac arrest victims

CPR does not usually re-start hearts – It tries to keep the heart muscle and brain alive, and it delays the transition from a shockable rhythm to a non-shockable one. This transition drops your chance of survival seven-fold. It usually takes an AED and drugs to re-start the heart, and sooner is a lot better!

Eighty-five percent of all cardiac arrests occur in a private residence. The witness, if there is one, is usually about the same age as the victim. Heel Compression quadruples the number of people who can perform guideline-compliant chest compression ("GC3’s") for ten minutes.

If there is nobody in your home that weighs enough to perform 2" deep chest compression until the ambulance crew is "hands-on" you really ought to consider purchasing a personal AED for home and travel use. My wife and I have one. (SLICC will be running another AED Group Purchase this fall. Let if you want to learn the details when the program is beginning. SLICC does not profit from this program.)

Your ability to perform GC3’s for ten minutes does not depend upon your strength, it depends upon the stiffness of the victim’s chest, your weight and weight distribution, and the method of chest compression you use.

The three largest flaws in how Bystander CPR is performed are:

  1. Leaning i.e.,  leaving too much force on the breastbone at top of the “full recoil" stroke. Leaning keeps dead people dead. 
  2. Very rapid chest compression - 120-150 compressions per minute was common in the nearly 400 EMS workers measured.  Compressions  in excess of 120 per minute reduce the probability of victims’ survival. 
  3. Compressions that are too shallow reduce the probability of victims’ survival.

Please watch the video at

Thank you.
What are the most serious problems with CPR?

FROM 10,000 feet:
  1. We're not focusing on training the people who most need to be trained. The people most likely to need to perform CPR are about the same age as - and live alone with - the victim.
  2. The technique most commonly taught is something that the vast majority cannot perform for ten minutes.
  3. Many of the people who will be called upon to perform CPR weigh too little to perform 2" chest compression on a chest of average stiffness.
  4. Even with free instruction, many people who need to know won't take the time to learn.
  1. We're not focusing the training on the people most likely to be presented with an opportunity to perform CPR on their spouse. More than 80% of the arrests involve people over 50. Given the ratio of male vs female arrests (2/3 are males) we should be training twice as many females as males, and we should be focusing on persuading both genders over 50 to get trained.Eighty-five percent of all USA Cardiac Arrests occur in a private residence - most are in someone's home, the rest in a nursing home - and the bystander that has to call 911 and start CPR is most likely the victim's spouse.  It's not always the case, but in general the spouse is about the same age as the victim. The CPR in the Schools program that we ran and that the SCA Foundation runs are valuable because it starts to sensitize young people at an early age and should eventually reduce the #4 problem.
  2. The CPR method being taught in the vast majority of cases - manual chest compression - is something that fewer than one in six can perform for ten minutes on an adult with an average stiffness chest. We have proven that the use of Heel Compression quadruples the number of people who can perform compression for ten minutes. The study was published in the American Journal of Emergency Medicine in October.
  3. Many potential rescuers don't weigh enough to perform guideline compliant chest compressions on their spouse. One's ability to perform guideline-compliant chest compressions is dependent upon the rescuer's weight, the rescuer's weight distribution, the stiffness of the victim's chest, and the method of performing compressions. An adult chest of average stiffness requires that the rescuer using manual compression weigh somewhere between 160 and 175 pounds, depending upon their weight distribution.  If the rescuer were using Heel Compression, the rescuer weight needs to be between 132 and 150 pounds. It's not always the case, but the female in the relationship is generally lighter than the male.
  4. Even if the training is available without charge (it is), not everybody who needs to learn will attend. We have trained more than 10,000 in Chatham  County, GA. Given that we know the age distribution of the victims, it would be reasonable to provide free, teacher-less videos ( and focus the Bystander Course instructor resource on the people most likely to need to know CPR: the folks over 50.