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CPR is the hype too great?

CPR and false expectations

Since it was introduced to American physicians in 1960, cardiopulmonary resuscitation has become a staple of emergency medicine but have the successes of this common procedure been over-hyped? Some would say yes. In fact, Dr. David Newman, who practices medicine at St. Luke’s Hospital in New York, claims that he has seen one patient walk out of his hospital after receiving CPR, and this is after 20 years of practicing medicine.

How can this be? We have all seen television shows where actors drown and are suddenly revived by cardiopulmonary resuscitation (CPR), but the truth is the number of individuals who survive CPR is very small, despite the fact that between 2011 and 2012, more than 14 million people in 60 countries were trained in CPR administration, according to the American Heart Association.

CPR has changed over the years

In recent years, the American Heart Association has begun teaching what they are calling a “hands only CPR” which requires the would-be rescuer to perform only chest compressions, approximately 100 per minute, without the combined mouth to mouth breathing. The American Heart Association argues the chest compressions should be sufficient to keep blood and oxygen circulating throughout the body until better emergency techniques can be performed.

The changes were also made with the hope that many would-be rescuers would be more willing to perform simple chest compressions without having to put their mouths against the mouths of strangers who were unconscious. Unfortunately, despite the CPR changes, the effectiveness and success rate for CPR remain low.

How low is low?

Experts agree that determining the survival rate for CPR recipients is hard to calculate, but in a 2012 study, it was report that “only about 2% of adults who collapse on the street and receive CPR recover fully.” Other earlier studies report a little higher success rate where “anywhere from 4% to 16% of patients who received bystander CPR were eventually discharged from the hospital.”

So why is there a disparity in the perception of successful CPR and the reality? Researchers claim most of the misconception is generated by television and movies. After watching episodes of Rescue 911, Chicago Hope and ER, researchers concluded that in television up to 75% of patients survived a heart attack after CPR, a stark contrast from reality. Experts also note that even if patients are given CPR and regain consciousness, it is likely they will lack full brain function, another factor not addressed in television.

What’s the bottom line with CPR?

Medical experts suggest CPR is still useful and should be learned and performed, but it is important not to expect a miracle. Others argue that even if CPR is relatively ineffective it is still the best alternative, and until medical experts identify an alternative, emergency providers should continue to do what they know. Other EMTs suggest it has more to do with the attitude of the reviver. Some EMTs claim, “If you put your heart into reviving them, they will come back." Unfortunately, that claim sounds like it was written for television.
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