New CPR Guidelines Stress Chest Compressions over Mouth to Mouth

Credit: Flickr/ValleeC

Chest compressions should now be done first when performing CPR

For years, the basics of performing CPR followed the steps A-B-C (Airway, Breathing, Chest Compressions). Now, new guidelines have switched the steps to C-A-B, beginning chest compressions as soon as possible

Last updated five years ago, the guidelines recently released by the Heart and Stroke Foundation of Canada and other international groups support the benefits of compression-only CPR, without the need for mouth-to-mouth resuscitation.

The most crucial step is to maintain blood flow around the body by rhythmically compressing the patient’s chest, hard and fast.

Taking time to perform the other steps first can actually jeopardize survival because without oxygen, the brain can die within four to five minutes.


CPR Chest Compressions Pump Blood to Brain

The revised guidelines recognize that patients will still have oxygen in their lungs and bloodstream within the first few minutes of suffering cardiac arrest, so starting CPR and chest compressions can pump that blood to the brain sooner.


What’s more, simplifying CPR guidelines can make it easier for more people to offer help when someone’s heart stops beating.

A recent survey of those trained in CPR found that 60 per cent would be hesitant to try to revive a person who had collapsed. Among the reasons given: lack of confidence in their skills, fear of doing harm, and some reluctance to perform mouth-to-mouth resuscitation for fear of contracting a disease.


Taking these factors into account, the new guidelines emphasize that even untrained bystanders can start chest compressions by firmly pushing down in the centre of the chest, depressing the breastbone by about two inches.

The Heart and Stroke Foundation emphasizes that technique is less important than doing compressions firmly and quickly. Reassuringly, the reported number of injuries from performing CPR is low and the benefits far outweigh the risk of doing nothing at all.

For those trained in CPR, chest compressions still come first, then after 30 compressions, checking the airway and performing two rescue breaths.


For those who suffer an out-of-hospital cardiac arrest, the statistics are abysmal: Fewer than five per cent survive, and each year, about 40,000 Canadians die.

The Heart and Stroke Foundation says the odds of surviving are almost four times greater if CPR is started right away. If CPR is combined with the use of an automated external defibrillator, survival rates go up to 50 per cent or higher.


What to Do in the Event of a Heart Attack

If you discover someone who is in cardiac arrest, do the following:

1. First ask bystanders to call 9-1-1.
2. Then immediately start compressing the person’s chest at 100 beats a minute. One way to remember the rate is to follow the tempo of the Bee Gees tune “Stayin’ Alive.”
3. Keep it going until paramedics arrive or an automated external defibrillator can be used to restore a normal heartbeat.

The reported number of injuries from performing CPR is low and the benefits far outweigh the risk of doing nothing at all

Originally published in TV Week. For daily updates, subscribe to the free TV Week e-newsletter, or purchase a subscription to the weekly magazine.