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The changing world of Cardio Pulmonary Resuscitation: The American Heart Association is promoting a new method of administering CPR.

December 17, 2011
Story, photo by Steve Browne , Marshall Independent

Since the American Heart Association came out with new guidelines for Cardio Pulmonary Resuscitation (CPR), emergency medical care professionals and lay-persons who want to be ready for emergencies have gone back to class to re-learn their ABCs.

"The sequence for CPR changed from ABC (Airway, Breathing, Compression) to CAB (Compression, Airway, Breathing), which is more focused on compression," said Kim Abraham, educational assistant at Avera Marshall Regional Medical Center in Marshall. "In 2010 the American Heart Association updated their guidelines."

The new guidelines reflect the realization that the amount of oxygen in the lungs of someone in cardiac arrest does not matter if the blood is not circulating it to the brain and heart muscle. The AHA now recommends starting rapid chest compression right away, before adjusting the head to clear the airway and giving "the breath of life" mouth-to-mouth.

Article Photos

Registered Nurse Donita Bennett demonstrates the new method of CPR on “Andy” at Avera Marshall Regional Medical Center. Here, Bennett does rapid chest compressions to get the blood circulating.

"We're currently doing it with all our EMS quarterly training changes," Dan DeSmet, director of North Memorial Ambulance service in Marshall. "We follow AHA guidelines and incorporate them into our protocols. Clinical research found keeping the blood circulating keeps the heart muscle viable. If the muscle dies, the victim can't be revived."

DeSmet said ambulance personnel do training every four months with their medical director.

"It improves survival rates," said Angela Chesley, vice-president of patient care at Avera. "By changing the sequence the rescuers can start compression sooner, minimizing the delay."

Fact Box

CPR and AED (Automatic External Defibrillator) training is available at the Marshall Area YMCA on the following dates in 2012:

Jan. 8, noon-3 p.m.

Feb. 19, noon-3 p.m.

April 25, 6-9 p.m.

May 13, noon-3 p.m.

Cost is $40 for members,

$55 for non-members. 532-9622

CPR/AED classes at the Prairie Winds Chapter of the American Red Cross in Marshall

(301 South 2nd St.) in 2012 are:

March 12, 8-11:30 a.m. ($90)

March 14, 5:30-8:30 p.m. ($70)


(A CPR certificate is valid for two


Chesley said they used to teach "Look, Listen, and Feel" for breathing but don't anymore because bystanders in stressful situations would tend to forget to do CPR if they heard a patient gasping for breath.

"The AHA had done a comprehensive study of survival times and found there's enough residual oxygen in the lungs," said CPR instructor Becki Johnson. "You don't need to have breath first to oxygenate the blood. With any delay in chest compression there is a decreased chance of survival."

Though the new technique is acknowledged to be more effective, part of the motivation for the change was that nowadays many people are worried about the chance of coming into contact with people with HIV or hepatitis via mouth-to-mouth breathing. People who are not professional medical personnel may omit the mouth-to-mouth breathing entirely if there is no breathing barrier available, according to Marshall area Red Cross Director Colleen Grothem.

"Lay responders can forgo the breathing," Grothem said, "though professionals may not. They have taken an oath to render assistance in all cases. Anyone with qualifications below a nursing degree is not considered a professional. For instance, a life guard with CPR training is not considered a professional."

Grothem cautioned that flat breathing barriers such as a piece of cloth, or the ones found in simple first aid kits are not effective in preventing contact with potential infectious agents.

CPR training is available from the Red Cross several times a month, and at the Marshall Area YMCA.

DeSmet said Tim Birkmeyer, regional EMS educator, will be conducting CPR instructor training at the Marshall Fire Department this weekend.



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