It’s that time of the decade, again: the new scientific best practices for CPR and BLS, established every five years by an international summit, have just been released this last Thursday. It’s an exciting time, seeing as we’re passionate about equipping the broad-scale population with life saving know-how. This is the chance for improvement, breakthrough, and innovation. The chance to drastically improve the guidelines on how to do CPR. Surely scientific inquiry on the international stage has yielded some data that require sweeping reform, promising better results and more lives saved with fewer complications…?
Except, well, it hasn’t. Aside from a few changes in instructional methodology, which are exciting in their own right, the ILCOR guidelines for CPR and BLS in 2015 are pretty stale, full of “reiterations” and “continued emphasis.” Sure, they’ve fiddled with some of the numbers, and we’ll discuss those here, but the practice of CPR remains wholly unchanged according to the top scientists in the field.
This is fantastic news.
Here’s why: now that we’ve gone five years without trying to rewrite the book on how CPR is best performed, the true nature of CPR can become more widely apparent. Its true nature, of course, is that it is simply a way to lengthen the window of time for lifesaving care, not lifesaving care in itself. In cardiac arrest cases, if no AED is applied and if emergency medical services are never called, CPR is statistically not going to save a life. It just won’t. That’s not its job. This distinction deserves to be commonly understood, and if scientists have finally run out of ways to tweak the numbers and overhaul acronyms, then it will be.
The biggest changes are in the approach to training. The guidelines heavily de-emphasize instructor based training, stating that in terms of resources and numbers of effectively trained personnel the blended model of individual training is at least equal, if not superior, depending on the program. This is huge news. The shift from inconsistent and archaic classroom CPR training to an accessible, effective, uniform program is inevitable, and in keeping with cultural trends. This is the beginning of a reform in CPR education, at which Pro Trainings is on the leading edge, indicated by its acceptance even in traditionalist circles. Nothing to come out of the summit trumps this: at this point, more lives will be saved by widely taught, quality education than any further fine tuning.
Briefly, though, let’s discuss the yield of this cycle’s scientific inquiry. In 2010, ILCOR supplied us with a few hard numbers. Chest compressions should be performed at a minimum of 100 beats per minute, at a depth of at least 2 inches. The 2015 guidelines improve on these figures by supplying a ceiling, a limit. Data indicates that compression rates should not exceed 120 bpm, and should never exceed 2.4 inches in depth. To reiterate, instead of a benchmark, we have a range: compressions should be between 100-120 bpm and between 2-2.4 inches.
This is good stuff. What’s interesting there is the range of depth. If a specific range is optimal, the question is how to train a person to stay within that range. Further, the guidelines for education state that a trainer is incapable of judging whether a student is achieving proper depth with the naked eye. To accurately train, then, it’s strongly recommended that manikins be equipped with feedback to indicate proper rate, depth, and hand position. There is no mention of manikin reform yet, but anticipating such reform in the near future would be wise.
Our own training will reflect the changes made by no later than Jan 1st, 2016. Remember that, in an emergency, even “outdated” models of CPR are effective: getting involved is more important than precise adherence to any mnemonic device, and a life could depend on your efforts. Stay safe, and stay tuned for where Pro Trainings is leading the industry in individual education.