Rescue breathers keen but not skilled enough

By REBECCA WALSH health reporter

Most New Zealanders think they could save a relative's life with CPR (cardiopulmonary resuscitation) but cannot perform the technique properly.

A New Zealand Medical Journal study shows that although three-quarters of those surveyed had been taught cardiopulmonary resuscitation (CPR), less than 10 per cent knew how many chest compressions a person should be given and how often they should perform mouth to mouth.

Yet CPR combined with a rapid ambulance response improved a person's chance of surviving a cardiac arrest by two to three-fold, they said.

The researchers questioned 400 Wellington people over the telephone about their knowledge of CPR and attitudes towards resuscitation. Just over 60 per cent said they would perform mouth to mouth on a stranger and 72 per cent would perform it on a family member.

Nearly three-quarters wanted to know more about resuscitation than they did and 70 per cent thought that resuscitation should be a compulsory component of the Driver's Licence test.

Despite the fact that 74 per cent of those surveyed had been taught CPR, only 4 per cent knew the correct rate of chest compressions to give a person and only 9 per cent knew the correct compression-to-mouth to mouth ratio for CPR on an adult.

Overall knowledge was highest for those taught in the previous year.

"Although attitudes of the community toward CPR are positive, theoretical knowledge relating to basic CPR is poor. This suggests that present community CPR educational strategies have limited efficacy."

The researchers said it was possible that if people had been asked to physically perform CPR their performance could have deteriorated even further.

During 2002, more than 150,000 New Zealanders received formal CPR and first aid training. CPR is included in the school curriculum as an optional subject and provided in workplace first aid training by Occupational Safety and Health.

Dr Tony Smith, medical adviser for St John Ambulance, said that although most people would go their entire life without needing to perform CPR, it was an easy skill to learn. He urged people to take a first aid course and update it every five years.

"In reality, there is a small chance that it will be required during your lifetime and the chances are when that happens it will be a member of your family," he said.

"We know people who receive CPR are far more likely to survive their cardiac arrest than those who don't."

About three-quarters of cardiac arrests in Auckland happened in a person's home.

Dr Smith said that in about half the cases of cardiac arrest attended by ambulance staff, CPR had already been performed by members of the public. That had dropped from about 65 per cent of cases in the 1990s.

Anecdotal evidence suggested people were less likely to do CPR - possibly because they did not know how - rather than being less willing, he said. A small number were worried about catching an infectious disease.

"Mouth to mouth is extremely safe and the chances of a disease being transmitted is almost zero," he said.

Dr Smith said if people were unsure what to do, research showed chest compressions did "90 per cent of the good". While some people could be afraid of causing damage to the person, the overall threat to their life was worse if they did not receive CPR.

How to do CPR

* Open the airway and give two rescue breaths for adults or five for children. Then start chest compressions.

* To give chest compressions, push on the middle of the chest, over the lower half of the breast bone. The pushes should be fast and regular - just under two pushes a second (100 per minute). Push down about 4-5cm in adults or about one-third of the depth of the chest in children.

* For an adult do 15 compressions to every two breaths. For a child, do five compressions followed by one breath.

* If the child is under one give the rescue breaths into the nose or the nose and mouth, not just the mouth.

Source: The New Zealand Resuscitation Council