Heart pressure massage instead of mouth-breathing

Cardiac massage instead of mouth-to-mouth resuscitation in acute cardiac arrest.
Heart pressure massages are the most important step in first aid. This has been clarified by the European Resuscitation Council (ERC), the American Heart Association and the International Liaison Committee on Resuscitation in the jointly developed new Guidelines on Resuscitation.

New simpler guidelines
Of the approximately 500,000 people who suffer a sudden cardiac death each year in Europe, the ERC estimates that up to 100,000 lives could be saved if the emergency kits present would provide more efficient first aid. However, the persons present are mostly lay people, who, for fear of mistakes, often hesitate to intervene or do not know what to do. Since every minute without first-aid measures initiated significantly reduces the chances of survival for patients, the associations in question felt obliged to provide the emergency services with new, simpler guidelines for first aid. The regulations now laid down apply, inter alia, to Europe, North America and Australia.

Changed sequence of measures
One of the most important innovations: the sequence of first aid measures in unconsciousness with intermittent or irregular breathing has changed. Instead of orienting themselves to the so-called A-B-C rule - "Airway", "Breathing", "Chest compressions" - emergency medical devices should in any case begin with chest compressions in the future. In the first few minutes, this is often sufficient as the sole measure, since the oxygen content in the blood is high enough even without ventilation for the time being. A new rule of thumb is C-A-B, whereby first responders, who shy away from mouth-to-mouth resuscitation, can only work with chest compressions until the ambulance arrives. Dr. Burkhard Dirks, emergency physician at the Ulm University Hospital and chairman of the German Council for Resuscitation, advises emergency vehicles: "Stay calm and, if possible, call someone to help them make an emergency call and assist with resuscitation." Then should „emergency vehicles themselves (...) immediately begin the revival, "said the chairman of the German Council for Resuscitation.

Heart pressure massages also by laymen applicable
The chest compressions can also be used safely by laymen. At least 100 times per minute, the paramedics should press the patient's chest approximately five centimeters deep to support the pumping function of the heart and continue to supply the vital organs with blood and oxygen. This procedure should be maintained until the arrival of the emergency doctor, whereby it is important to press hard enough during CPR massage and not to interrupt it. For the emergency vehicles, this can also be physically a very stressful situation, because on average it takes seven minutes until the rescue teams are on site. „Cardiac massage is physically very exhausting. That's something a person can barely manage on his own until professional help comes in, "Dr. Dirks explained. Therefore, the emergency physician recommends that first responders be consulted by other persons present and that they alternate with the cardiac massage. As a rule of thumb, 30 compressions are followed by two ventilations, but the new guidelines for resuscitation advise all unsafe emergency medical professionals to focus exclusively on chest compressions.

Survival increased significantly
The new CPR Guidelines are based on the current state of research, according to which cardiac massage is the most effective remedy for laymen. Thus, physicians at the University of Vienna recently examined 3,700 cardiac arrest patients in three studies. These showed that more emergency patients survive when the inexperienced helpers were instructed by the rescue center after the emergency call to immediately start with the chest compressions and to renounce the ventilation. It also increased the chance that the victims can be revived without permanent damage, as the brain is still supplied with oxygen and otherwise would take significant damage after only five minutes. According to the Björn Steiger Foundation, 247 people in Germany die of sudden heart failure every day, and around 400 people are resuscitated outside hospitals. Of these, only one in ten remains alive. Conversely, if emergency medical devices already begin resuscitation before the ambulance arrives, the patient's chance of survival is increased by a factor of 2.5.

Hope for more first responders
Co-editor of the German version of the new version „2010 Guidelines for Cardiopulmonary Resuscitation and Cardiovascular Emergency Medicine“, Dr. Heinzpeter Moecke, stated in her public presentation: „We hope that now more people will be able to resuscitate in an emergency and that a few hundred lives per year will be saved in Germany. "According to the expert, less than one third of people with cardiac arrest have been helped by emergency witnesses Often fearful of doing something wrong or exacerbating the situation, the new guidelines may also reduce the fear of helping, says Dr. Heinzpeter Moecke. „For the layman, the first aid is easier and clearer, because he should focus on the cardiac massage and the ventilation is less important in the foreground, "said the expert Patients present, a heart massage can help to regain consciousness, said Dr. Moecke.

In order to prepare themselves for such situations, the expert advises to visit first aid courses on a regular basis and to refresh one's own knowledge about the methods of resuscitation. "This is the only way you can stay up to date and help your family, friends and those around you as effectively as possible in the event of an emergency. Moecke. As part of the new guidelines, the experts also recommend the use of defibrillators, which are easy to use and now publicly available in many places. However, as with manual cardiac massage, here too the treatment should not be interrupted until rescue workers arrive. (fp, 20.10.2010)

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