Push Hard Push Fast
January 3, 2014

Push Hard And Fast: The American Heart Association’s Public Awareness Campaign

Push hard and fast. These are the two steps that the American Heart Association recommend in their “Hands Only CPR” campaign. You may have seen the commercials on television, as they have recently started buying airtime in hopes of educating a wider audience of the public.

Here is one of my favorites with actor/comedian (and also physician), Ken Jeong from “The Hangover.”

Although “Hands Only CPR” has been a part of the AHA’s campaign for public education for a while now, it seems that public awareness is still lacking. Bystander CPR is vital in the treatment of sudden cardiac arrest. In statistics published by the American Heart Association, 88 percent of cardiac arrests occur at home. While cardiac arrests victims that receive immediate and adequate CPR can have their survival rates increase by double or sometimes triple, only thirty-two percent of those out-of-hospital arrest victims receive immediate CPR.

This approach to bystander CPR is an attempt to simplify the process as well as make it less intimidating. Their website states that if you see a teenager or adult suddenly collapse, call 9-1-1, begin chest compressions, and press hard and fast until and AED arrives or an EMS crew arrives to take over care.

Hands Only CPR is just what it implies: CPR using only the hands as it takes giving breaths at predetermined intervals out of the equation. By removing the interruption of chest compressions to give breaths, they want to focus on the most important aspect of CPR: circulating blood throughout the body. And, yes, as Dr. Jeong states in the video, you can use the beat of “Stayin’ Alive” by the Bee Gees to drive your compressions (although, if you are a little morbid, you could also use the beat of “Another One Bites the Dust,” by Queen).

The most common question I get when introducing this CPR program to the public is, “What about the breaths? What is the point of circulating blood if you are not delivering oxygen?” Well, by taking a look at the process of mechanical ventilation (the physical act of moving air in and out of the lungs), we can see that although we are not forcing air into the lungs, we are still ventilating the patient through the body’s natural process of creating negative air space in the chest cavity. Let me explain:

Mechanical ventilation is accomplished when the body expands the chest cavity to create a negative air space. The diaphragm and intercostal muscles contract allowing air to fill the larger space. They then relax allowing the cavity to shrink and push the air out.

Think of the space inside your chest, including the lungs, as an empty water bottle. If we were to compress the outside of this bottle approximately two inches, the same compression depth recommended by the AHA, air would be pushed out of the bottle into the surrounding airspace. Once we let off of the bottle and allow it to recoil back to its normal shape, we would see that air is sucked back into the bottle from the negative pressure we created by the compression. So, as you can see, with each compression we are not only circulating blood, but we are also ventilating the patient as well.

Hopefully, this newer, simpler form of CPR will prompt more involvement from the public during a witnessed cardiac arrest. For those who wish to seek formal training on CPR and what to do in other sudden medical emergencies (such as stroke and choking), you can contact your local ambulance service, fire department, or visit the American Heart Association’s find a course webpage where they offer both online and traditional classroom training courses.

Image Credit: Thinkstock

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