Push to revive CPR skills in bystanders

The use of CPR is getting a breath of fresh air from the St John first-aid training service, which wants to halt the sliding rates of bystander intervention in medical emergencies.

St John medical adviser Tony Smith says that in the past decade the percentage of bystanders providing CPR - cardiopulmonary resuscitation - to unconscious people when it's needed has fallen from about 65 per cent to 45 per cent.

Dr Smith said yesterday that the reasons were unclear but it was probably a combination of fewer people taking first-aid courses and increased resistance to "interfering" with a stranger.

"But we are even getting examples of people not being helped in their own homes."

He said the trend was a concern as New Zealand data had shown that bystander CPR improved the chances of a person surviving cardiac arrest by about 30 per cent.

A new training strategy released by St John yesterday aims to simplify the procedures of CPR and boost people's confidence in giving it a go.

Dr Smith said there had, for instance, been confusion about chest compression-to-breath ratios.

The simplified rule, for children and adults, was 30 compressions to two breaths, best remembered as "Thirty to two no matter who".

"The compressions keep the blood flowing around the body and are more important than the breaths."

Dr Smith said people needed to get their hand on the centre of the chest, between the nipples, place their other hand on top and press hard.

Broken ribs could be a side-effect but that was not important.

People should continue CPR until an ambulance arrived, which could be up to 10 minutes, or until they were too exhausted to continue.

In car accidents, unconscious people should be moved if that was necessary to get their airways open and to perform CPR.

Dr Smith said people worried too much about finding a pulse. They should forget that and start CPR when someone appeared unconscious.

The procedure would not seriously harm the person even if their heart was already beating.

Dr Smith said bad CPR was better than no CPR, but he urged people to learn how to do it properly.

First-aid courses had been too complicated over the years, which had reduced their effectiveness.

Thomas Kaminski, St John's education services manager for the northern region, said bystanders might be too preoccupied with whether they were doing the right thing. Perceived liability issues could put them off trying to help.

"People are too scared to make the wrong choice ... This is what we are trying to address."

Under the new training scheme, people would take home an instruction video and their own Mini Anne mannequins to practise on.

Four out of five people provided with Mini Annes were shown to have gone home and practised on them.

The Mini Anne users were also 21 per cent more likely to display better CPR techniques two months after training than those who learned CPR by older methods.

Cricket great Sir Richard Hadlee, who helped to launch the new training, said he had regularly been a patient of St John because of injuries.

But his biggest scare came when he developed heart problems while watching a game of cricket at Carisbrook in 1991.

He went immediately to Dunedin Hospital by ambulance and within 15 minutes had had a cardiac arrest.

"So at any time one may be called on to act quickly and save a life."

WHAT TO DO

* Don't waste time searching for a pulse.
* Start procedure if person appears unconscious.
* Signs include lack of movement and breathing.
* Place one hand over the other in middle of person's chest.
* 30 rapid chest compressions to every two full breaths.
* Press hard, less so for children, and don't worry about breaking bones.
* Lift patient's chin and tilt their head back.
* Seal their mouth with your lips and pinch their nostrils closed.
* Give them full breaths so their chest rises.