Cardiopulmonary Resuscitation (CPR)

What is CPR?

Cardiopulmonary Resuscitation (CPR) is a life-saving skill that everyone can and should learn. At a minimum, CPR requires someone to perform chest compressions, manually pumping blood through the body so oxygen can be delivered. The addition of ventilation, through rescue breathing, can also improve the victim’s chances of survival, as can the use of a defibrillator to administer electrical shocks to restart the heart or change its rhythm, if needed. Healthcare professionals are generally required to maintain CPR certification, but the average person willing to get involved can become an Immediate Responder, and improve a victims chances of survival by learning and performing CPR until EMS or other advanced help can arrive.

Basic CPR training includes recognizing a victim in need, ensuring scene safety, checking for responsiveness, calling for help, learning and practicing the proper techniques for giving chest compressions and rescue breathing, and understanding and practicing how to implement Universal Precautions to protect from potentially transmitting or contracting an infectious disease. Learning to use an Automated External Defibrillator (AED) has also become a standard for training, although there may not always be one available.

Our understanding of the human body continues to grow and CPR procedures continue to evolve as we learn more through specific scientific research conducted on resuscitation techniques, and medical devices are invented to improve their effectiveness. In fact, CPR standards are generally updated every four to five years to reflect these realizations, so just because you took a class once upon a time, and aren’t required to carry a certification card, doesn’t mean you never have to take another class; because you absolutely should continue taking the training periodically if you are truly dedicated to saving another person’s life.

The Origins & Evolution of CPR

Although modern CPR techniques were first introduced in the 1950s, they developed from a variety of related skills, some of which date back as far as the 1530’s, and there is even some evidence to suggest that the ancient Egyptians used similar techniques in their time. Today’s various iterations of CPR are the evolution of the procedure the American Heart Association first began promoting in 1960, as well as the integration of medical device discoveries that improve victim’s chances, and CPR has and will continue to evolve with the advancement of new medical technology and an increased understanding of the human heart, lungs, circulatory system, and brain, as well as what makes resuscitation techniques most effective.

Some significant advancements in techniques and procedures due to medical device invention include those sparked by the AMBU Bag and Automated External Defibrillator (AED). Originally, ventilation was only provided via mouth-to-mouth rescue breaths, although there was some use of a bellows in 1530 as well as other devices used for mechanical ventilation along the way. In the late 1950’s however, Healthcare Professionals began ventilating their patients using a device called an AMBU Bag, but now generically known as a Bag-Valve Mask (BVM). To this day, the BVM is standard issue equipment in both pre-hospital and in-hospital care settings. While the first AED developed for public use was introduced in the late 1970’s, widespread acceptance and use only began in the U.S. in the early 1990’s, and it wasn’t until 1995 that American Heart Association CPR protocols were changed to adapt their use.

The American Heart Association has a page dedicated to a much more complete History of CPR on their website.

Basic Life Support (BLS)

While all CPR is designed to be life saving, those in Healthcare Professions, including First Responders, are taught additional skills that build on training they already have and use on a daily basis, as well as advanced medical devices and protocols, all designed to increase the patient’s chances of survival. They also have advanced therapies and medications at their disposal, and are taught to work as members of High Efficiency Teams both inside and outside of hospital settings. There are multiple levels of life-saving training and certification for Healthcare professionals, but the foundation for all of them begins with medical provider CPR, also known as Basic Life Support (BLS).

Layperson or Bystander CPR

The average person who doesn’t work in the medical field is still very important to the life saving process, in fact they may be even more important since every second counts when a person isn’t breathing or their heart stops, and it takes time for EMS to arrive. A bystander who isn’t a Healthcare professional but takes action to save a victim’s life is referred to as an Immediate Responder. The level of CPR training these individuals receive is called HeartSaver CPR by the American Heart Association but the American Red Cross and Health Safety Institute simply refer to it as CPR.

If you need a certification card for your employer, or just want one for yourself, then you’ll want to take one of these courses. If you don’t need or care about proof of certification but still want to learn the skills to become an Immediate Responder, you should look for a Friends and Family CPR course, and if you’re concerned about giving breaths or want to learn something right away before you’re able to attend a more comprehensive course, you can take an online Hands Only CPR course.

Hands Only CPR

As previously pointed out, performing CPR normally includes giving both ventilations and chest compressions, and while Healthcare Professionals typically use a BVM to ventilate, the average person doesn’t carry one, nor are they trained in its use. For this reason, the general public still primarily uses mouth-to-mouth rescue breathing, something not everyone is comfortable with, especially post-pandemic. In reality, this lack of comfort more likely began in the 1980’s, when fear of the spread of AIDS sparked terrifying rumors, causing people worldwide to take the potential transmission of infectious diseases much more seriously.

These concerns prompted the development of small single-use protective breathing barriers, called pocket masks, for those not working in the medical profession, and at a minimum the use of rescue masks for those who were. In fact, use of such devices is now strongly recommended when performing CPR, to reduce the chance for transmission of infectious diseases through the exchange of bodily fluids like saliva or blood. Unfortunately, even with the evolution of more advanced breathing barriers and relatively inexpensive and easy to carry rescue masks for use by the general public, studies concluded that as many as 70% of bystanders admit to being slow or completely reluctant to perform CPR, many due to fear of infectious disease transmission.

Realizing this, the American Heart Association undertook extensive research and testing, then presented the alternative of Hands Only CPR to the public in 2008 and launched a campaign in 2012 to further promote it. Basically, Hands Only CPR is exactly what it sounds like, you call 9-1-1 or ask someone else to do so, then perform chest compressions on the victim who requires CPR, until more advanced help arrives. If you’re interested in learning Hands Only CPR, you can watch training videos produced by the American Heart Association or American Red Cross by clicking on their names here.