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Forget CPR, Give CCR Instead

Adults Who Collapse Need Chest Compression, Not Mouth-to-Mouth
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How to Do CCR for Cardiac Arrest

A cardiac arrest isn't the same as a heart attack.

"A heart attack is a plumbing problem, and a cardiac arrest is electrical," Peberdy says. "A heart attack is a block in a pipe, and unless the pipe unclogs the heart muscle will die. A cardiac arrest is a sudden catastrophic electrical problem where the heart cannot beat at all. Cardiac arrest equals sudden death. You die unless you are resuscitated."

People who suffer cardiac arrest suddenly collapse. In adults, a collapse is almost always due to cardiac arrest.

"If someone suddenly collapses, you can help, but if you do nothing, that person will almost certainly die," Bobrow says. "Activate the 911 system, position the victim with head tilted back so the airway is open, and then immediately start rapid, forceful chest compressions. Lock your hands together one on top of the other, put the heel of the lower hand in the center of the victim's chest, and push hard and fast, 100 times per minute. If you are lucky enough to have an AED [automated external defibrillator], attach it to the victim and follow the commands."

Don't worry about mouth-to-mouth resuscitation or compression-to-breath ratios, Bobrow says. And don't worry about pushing too hard. The chest has to be depressed about 2 inches. Even if you crack the victim's ribs, you'll be doing much more good than harm.

"You can't make anything worse. All you can do is help," Bobrow says. "Keep up the compressions until help arrives. If you get tired, have another person take over for a while."

"The best message we can send people is, if they witness a cardiac arrest, push hard, push fast, and don't stop until the emergency responders get there," Peberdy says.

Mouth-to-mouth resuscitation still has a role in patients with respiratory arrest. But Bobrow and Peberdy say that the vast majority of adults who collapse have cardiac arrest. Since cardiac arrest is rare in children younger than 8 years of age, rescuers should suspect respiratory arrest when young children collapse. Traditional CPR is still recommended for these young children.

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