C-A-B: The new CPR guidelines.

At some point in your novel, perhaps you'll have a character that has a life-threatning event and will require CPR. If so, it's important to know that there has been a big change in how CPR is delivered to victims from lay people all the way to the healthcare professional.

Why change? Every five years, the American Heart Association (AHA) examines available scientific study to determine if the current guidelines are the best way to resuscitate a patient who is not breathing and does not have a pulse. Over the last ten years, what's been found, is that compressions are paramount to delivering residual oxygen loaded up on hemoglobin to the cells. The only way to do that is to keep the blood moving.

Another couple of components was the general discomfort among the lay public to initiate CPR, particularly mouth-to-mouth resuscitation. Also, several studies showed that people (including healthcare professionals) were not that great at determining whether or not the patient was breathing and/or had a pulse. Some people mistook agonal respirations (which are gasps of air when a patient is near-death) as breathing and thus would delay support of the patient.

In the new guidelines, there is a quick check for responsiveness. If not responsive and you're alone, you should get an AED if one is available and call 911. Then return to the patient and attempt resuscitation by starting chest compressions. If you're with someone then one stays with the patient to perform CPR and the other will get the AED if available and call 911.

The sequence goes as follow:
1. Check the patient for responsiveness and no breathing.
2. Call for help.
3. Check the pulse for no more than 10 seconds.
4. If no pulse, give 30 compressions.
5. Open the airway and give 2 breaths.
5. Resume compressions.

Consider these new AHA guidelines when writing scenes that involve resuscitating a patient. Another thing to keep in mind is that some fire departments are instituting protocols whereby the arriving EMT and/or paramedic will provide 200 compressions before delivering a shock as a way to "prime the pump". This has been shown to increase the effectiveness of electrical defribillation. If you're writing a location specific novel, check the local fire department to see what their protocol dictates.