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This scientific advisory amends the 2005 Guidelines on Hands-Only™ CPR (compression-only CPR) by increasing the circumstances for which Hands-Only™ CPR is recommended. Previously, use of Hands-Only™ CPR was recommended only for: "Laypersons... who are unable or unwilling to provide breaths..." and for dispatcher CPR instructions to bystanders by telephone. Recently published evidence demonstrates that Hands-Only™ CPR can be as effective as conventional CPR (CPR with breaths) when performed by bystanders. Therefore, the AHA now recommends that Hands-Only™ CPR can be used by any bystander who witnesses an adult suffer a sudden collapse outside of the hospital setting.
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Hands-Only™ CPR is CPR without mouth-to-mouth breathing. It consists of two steps:
Hands-Only™ CPR is recommended for use on teens and adults (anyone over the age of 8) whom you witness suddenly collapse.
The method was created to build bystander confidence and participation to assist adults experiencing a sudden cardiac arrest. It is not a conventional CPR course. People who have not been trained in CPR within the last 5 years state that they are more likely to perform Hands-Only™ CPR than conventional CPR (with the breathing technique) for an adult who suddenly collapses. Hands-Only™ CPR is easy to remember and is an effective option for those bystanders who may be hesitant to help.
Yes; CPR can cause fractures. In studies of people who have received such injuries from CPR, the fractures did not cause serious internal bleeding. Besides, a couple of fractured ribs are better than death.
On average, any attempt to provide CPR to a victim is better than no attempt at all.
Continue to provide hard and fast chest compressions with minimal interruptions to the best of your ability. Giving good-quality chest compressions 100 times per minute is hard work; most people will get tired after only a few minutes. If someone else is nearby, ask that person to take over chest compressions after about two minutes or about 200 compressions. If you are alone, just do your best.
When an adult experiences cardiac arrest, their lungs and blood contain enough oxygen to keep vital organs healthy for several minutes. Providing high-quality chest compressions will circulate that oxygen-rich blood.
Call 911 and start CPR.
Adults who suddenly collapse and are not responsive are likely to have sudden cardiac arrest and their chance of survival is nearly zero unless someone takes action immediately. You should call 911 and start giving hard and fast chest compressions in the center of the chest. If sudden cardiac arrest is the cause of the collapse, Hands-Only™ CPR is an easy, effective way for any bystander to more than double the victim's chance of survival. If an adult has collapsed for reasons other than sudden cardiac arrest, Hands-Only™ CPR should still help by causing the person to respond (begin to move, breathe normally or speak). If that occurs, Hands-Only™ CPR can be stopped.
Any attempt at CPR is better than no attempt. Hands-Only™ CPR performed by a bystander has been shown to be as effective as conventional CPR with mouth-to-mouth breaths in the first few minutes of an out-of-hospital sudden cardiac arrest. Conventional CPR may be better than Hands-Only™ CPR for certain victims, such as infants and children, adults who experienced an un-witnessed cardiac arrest, or victims of drowning. For information about upcoming Hands-Only™ CPR classes see our Registration Page. For information about CPR and AED certification, see our Sessions Page.
This recommendation clarifies and elaborates the 2005 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. Those guidelines noted that there was a need to increase the prevalence and quality of bystander CPR. The guidelines also contained the recommendation that laypersons should do Hands-Only™ CPR (the guidelines used the term "compression-only CPR") if they are unable or unwilling to provide breaths.
Since the publication of the 2005 AHA Guidelines, several studies showed that Hands-Only™ CPR can be as effective as conventional CPR (CPR with breathing) in the out-of-hospital setting. As a result, American Heart Association volunteer scientists authored an Advisory Statement for the Public. This Advisory Statement, Hands-Only™ (compression-only) CPR: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest, was published in the journal Circulation on March 31. The statement applies to bystanders who see an adult collapse suddenly in the out-of-hospital setting. The purpose of this statement is to encourage the use of Hands-Only™ CPR by untrained bystanders and by trained bystanders who are not confident that they can perform conventional CPR. The statement also notes that trained bystanders who are confident that they can perform conventional CPR with minimal interruption to chest compressions can do so or they can perform Hands-Only™ CPR.
No. With the publication of the 2005 AHA Guidelines for CPR and ECC, the AHA emphasized that the most critical component of performing CPR is delivery of high-quality chest compressions with minimal interruptions. That remains true and can be accomplished for all victims of cardiac arrest using conventional CPR, that is, CPR with breathing (mouth-to-mouth). AHA experts recognize that mouth-to-mouth breathing is a relatively complex skill. If rescuers have not practiced the combination of breathing with chest compressions, the delivery of breaths can result in long and potentially detrimental interruptions to chest compressions. In addition, recent evidence demonstrates that bystander Hands-Only™ CPR is as effective as conventional CPR in the first few minutes of out-of-hospital sudden cardiac arrest. Therefore, Hands-Only™ CPR is now considered an appropriate bystander response to out-of-hospital adult sudden cardiac arrest. The breathing (mouth-to-mouth) component of CPR remains important in the treatment of other cardiovascular emergencies: