Like it or not, we live in a 24/7 news cycle where health and medical stories, such as the benefits or dangers of coffee, seemingly change every other day. “Chest compression-only” CPR is the most recent example of a medical and health related story that has generated quite a bit of interest and discussion. As an instructor and provider of American Red Cross CPR and First Aid training, I am often approached about the effectiveness and value of chest compression-only CPR. From time to time I have people tell me they heard that chest compression-only CPR is what “they” are recommending.
The New England Journal of Medicine recently published two studies regarding the effectiveness of compression-only CPR. The purpose of this article is to clarify what the studies found and provide the reader with the information necessary to evaluate what type of training should be provided in the workplace.
The key findings of the articles are that dispatcher guided compression-only CPR has an equal outcome to full CPR (chest compressions with rescue breaths). However, there may be a trend toward better outcomes in certain types of cardiac arrest victims (heart disease for example). Both articles then state (although not studied) that chest compression-only CPR is easier to learn and is therefore more likely to be performed by a bystander and that it should be advocated in certain situations.
It is important to note that neither article discourages employers or persons from learning full CPR and AED (automated external defibrillator) skills, it simply states that chest compression-only CPR may have outcomes equal to that of full CPR in certain situations. It is also important to note that one of the largest providers and sponsors of CPR, AED, and First Aid Training, The American Red Cross, supports the use of chest compression-only CPR for those persons who are unwilling, unable, or not trained to perform full CPR, but encourages all persons be trained in full CPR and AED.
The danger of not thoroughly reading and understanding these studies is that many people may interpret the studies to mean that chest compression-only CPR is now preferred over full CPR and use of an AED. A person’s reluctance to provide rescue breaths, perceived lack of coordination, and other factors may cause some persons to believe that chest compression-only CPR is now preferred over full CPR and use of an AED. No such statement was made in either of the two studies. The studies simply point out that chest compression-only CPR may have outcomes equal to that of full CPR in certain cases. My fear is that some persons and employers will use these studies to avoid learning, and staying current, with full CPR, AED, and First Aid training.
It should also be noted that OSHA has not yet addressed these studies and their effect in meeting the requirements many employers have in providing CPR and First Aid Training as required by 29 CFR 1010.151(b) and 29 CFR 1926.50(c). These standards require employers to provide trained personnel capable of providing life saving skills to employees exposed to life threatening injuries, such as falls, electrocutions, etc., in the workplace when advanced life support (services dispatched through 911) is not available within three to four minutes of the workplace or jobsite. The interpretation and standards also require trained personnel to receive certificates from “the American Red Cross, U.S. Bureau of Mines or equivalent training”. In other words, it is questionable if OSHA would accept studies that promote methods that do not rely on a formal training curriculum in providing life saving skills to injured or ill employees.
In summary, employers should not use these studies as justification to avoid providing formal training in full CPR, AED, and First Aid skills to designated employees. The study simply states that dispatcher guided and coached chest compression-only CPR can have positive outcomes. To stretch this study into a belief that chest compression-only CPR is preferred to formalized training in full CPR, AED’s, rescue breathing, and basic first aid skills is not advised and may expose the employer to possible violations of OSHA’s requirement to provide training in first responder life saving skills.
The official position of the American Red Cross on chest compression-only CPR can be found at: http://www.redcross.org/portal/site/en/menuitem.1a019a97 8f421296e81ec89e43181aa0/?vgnextoid=629a1a8526e1a210V gnVCM10000089f0870aRCRD .
| Gary Glader is President of Network Safety Consultants, a subsidiary of The Horton Group. He can be reached direct at 708.845.3662 or via e-mail at gglader@networksafetyconsultants.com. |