New CPR Promises Better Results by Compressing Abdomen, Not Chest

[ElsewheresDaughter]

http://www.docguide.com/news/content.nsf/news/852571020057CCF68525734E004BB174?Open&id=48DDE4A73E09A969852568880078C249&count=10

WEST LAFAYETTE, IN -- September 6, 2007 -- A biomedical engineer at Purdue University has developed a new method to perform cardiopulmonary resuscitation that promises to be more effective than standard CPR because it increases nourishing blood flow through the heart by 25% over the current method.

A new technique is desperately needed because conventional CPR has a success rate of 5% to 10%, depending on how fast rescuers are able to respond and how well the procedure is performed. For every one minute of delay, the resuscitation rate decreases by 10%.

"In other words, at 10 minutes, the resuscitation is absolutely ineffective," said Leslie Geddes, Showalter Distinguished Professor Emeritus in Purdue's Weldon School of Biomedical Engineering. "Any medical procedure that had that low a success rate would be abandoned right away. But the alternative is not very good, either: Don't do CPR and the person is going to die."

Geddes has developed the first new CPR alternative, called "only rhythmic abdominal compression," or OAC-CPR, which works by pushing on the abdomen instead of the chest.

"There are major problems with standard CPR," Geddes said. "One is the risk of breaking ribs if you push too hard, but if you don't push hard you won't save the person. Another problem is the risk of transferring infection with mouth-to-mouth breathing."

The new CPR method eliminates both risks, Geddes said.

Findings will be detailed in a research paper appearing this month in the American Journal of Emergency Medicine, published by Elsevier Inc. The paper was authored by Geddes and his Purdue colleagues Ann E. Rundell, assistant professor of biomedical engineering, biomedical engineering doctoral student Aaron Lottes, and basic medical sciences graduate students Andre Kemeny and Michael Otlewski.

In standard chest-compression CPR, which has been in practice since the 1960s, the rescuer pushes on the chest and blows into the subject's mouth twice for every 30 chest compressions. However, the risk of infection is so grave that many doctors and nurses often refuse to administer mouth-to-mouth resuscitation. In one 1993 study of 433 doctors and 152 nurses, 45% of doctors and 80% of nurses said they would refuse to administer mouth-to-mouth resuscitation on a stranger.

"This is the real world that nobody knows about, and it's a sobering thought," Geddes said.

OAC-CPR eliminates the need to perform mouth-to-mouth resuscitation.

more...http://www.docguide.com/news/content.nsf/news/852571020057CCF68525734E004BB174?Open&id=48DDE4A73E09A969852568880078C249&count=10

[liberalnurse]

1. Al I have to say is this.....

The CPR protocol for the past 20 years has worked fine.....The new CPR.....with these 30-2 chest compression/breathe ratio thing is a miserable failure in active practice. It's designed by those who read and theorize about treatment not preform it.

Now this!:spank:

[ElsewheresDaughter]

3. it was a nurse who discovered this new method of OAC-CPR

[liberalnurse]

7. Go figure!

:spank: :banghead:

[TwilightGardener]

4. Did they change it again? Last time I took ACLS (been a few years, I'm

not in nursing now), it had been changed, less breaths, more/faster compressions. Before that it was 15-2 (one rescuer) and 5-1 (two). Hell, it's a good thing I'm not in codes anymore, I can't keep up!

[liberalnurse]

8. Hell Ya, they changed it alrignt....

More like Isometric/Aerobic CPR...............

http://depts.washington.edu/learncpr/quickcpr.html

3. PUMP

If the victim is still not breathing normally, coughing or moving, begin chest compressions. Push down on the chest 11/2 to 2 inches 30 times right between the nipples. Pump at the rate of 100/minute, faster than once per second.




CONTINUE WITH 2 BREATHS AND 30 PUMPS UNTIL HELP ARRIVES


NOTE:
This ratio is the same for one-person & two-person CPR. In two-person CPR the person pumping the chest stops while the other gives mouth-to-mouth breathing.

[TwilightGardener]

10. Oh...the ratio is the same now for the # of rescuers--I guess that makes sense.

I also remember a new rationale that oxygenation was not quite as vital as perfusion (not that you're getting much of either), which is why they changed the compression-to-breaths ratio, and yes, 100 compressions a minute on a stiff sternum is not easy work!

[TwilightGardener]

2. Wow, that is really interesting! I always felt like I wasn't putting in enough

force during CPR, because I'm very small (under five feet) and a normal weight--just not enough "oomph" or leverage. And feeling the ribs and/or cartilage give way is a creepy sensation--ick. I could squish someone's belly, no problem. I wonder if it's the force on the great vessels that does the trick, or maybe there's more displacement (thus more of a vacuum) created to move more blood ? I wonder, though, about the possibility of liver lacerations or other similar trauma in the abdomen.

[NC_Nurse]

5. Couldn't that cause regurgitation and aspiration?

Seems like a bad idea to me. But I guess they have some data to back them up???

[liberalnurse]

9. Me too!

I can smell it now!:puke:


Another thought.................Can we say Abdominal Aortic Anerysm?

[TwilightGardener]

11. Mix some gastric distension in there, that would be a likely result--

I suppose you could stop CPR and turn/clear the airway, but that would be a concern.

[uppityperson]

6. Interesting, thank you. Abd compressions would get blood circulating

and oxygen into lungs. It will be interesting to see what develops with this.