ASK THE NURSE
Introduction to "Ask the Nurse" Column
by Helen Borel, RN,PhD
ASK THE NURSE is your column for answers to questions patients and their loved ones need to, or should, ask about the kind and quality of healthcare you are entitled to from your physicians, from your registered nurses, and from other professional staff when you're hospitalized or undergoing procedures in a so-called "ambulatory care" setting. And, too, about what you can expect from your prescription medications. Additionally, ASK THE NURSE will tackle any and all questions you have about anything and everything relating to your physical well-being and mental health.
The New CPR: Chest Compressions Alone
I'd like to start this column off with this very important question: Dear Nurse, If I find someone not breathing, is it true that chest compressions alone are sufficient for resuscitation to be successful?
Answer: Contrary to the decades-long cardiopulmonary resuscitation (CPR)trainings and practice of health professionals and CPR-trained ordinary citizens, it is now believed that "breathing for the patient" with your own breaths during resuscitation rescue procedures is not necessary - and might even do harm.
Mouth-to-Mouth Rescuers are Endangered
Not to mention, other than the possible harm to the afflicted non-breathing patient, we should also consider - which has usually, even by physicians and nurses, even by Red Cross CPR trainers, even by other professional CPR educators - that the widespread practice of mostly unprotected mouth-to-mouth breathing for the helpless patient has always been extremely dangerous for the rescuer.
Some reasons why include: TBC (tuberculosis), which has always been around, is an even more dangerous infection today. Because some more virulent strains of the tubercle bacillus are now stronger than (resistant to) the antibiotics which used to be effective against TBC. Tuberculosis surely can be contracted via the close contact of mouth-to-mouth breathing.
Herpes viruses - such as the circumoral variety - are easily caught by lip-to-lip contact, and Herpes viruses are lifelong body invaders, once contracted. Also, EBV (Epstein-Barr Virus), the cause of the so-called "kissing disease," known medically as Infectious Mononucleosis, is yet another threat to mouth-to-mouth respiration rescuers.
Additionally, the human immunodeficiency virus has been known to lurk in saliva, which would also put at risk of AIDS breathers-into-the-mouths of people-of-unknown-medical-history.
Finally, the new "SuperBug," MRSA (methacillin-resistant Staphylococcus aureus), which is lately bugging both hospital patients and healthy folks in ordinary communities, is a vicious infection and can be transmitted via airway contact.
Epidemic and otherwise contagious diseases are major reasons why mouth-to-mouth resuscitation practices have always been questionable to me. The only caveat is when the nonbreathing victim is your own child or another relative whose medical history you are sure of. Then mouth-to-mouth breathing could be justified.
Chest Compressions Alone Revive Respiratory Arrest Victims Safely
Today, medical experts recommend chest compressions alone to revive a nonbreathing person. In fact, this new protocol is apparently preferred. That is accordng to a discussion in the March 17, 2007 issue of the widely-respected medical journal,The Lancet. Apparently chest compressions alone, without rescuer airway contact with the victim's airway, provide just as good resuscitative benefits. And in some cases patients who'd been revived solely with chest compressions did even better.
So, if you're a bystander with CPR training, when someone stops breathing, doing chest compressions alone can save a life. Especially if you don't have special oral-nasal protection with you to shield you from very risky infections.
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