Further explorations on human body has paved the way for more discoveries on administering cardiopulmonary resuscitation and all of them are put to practice to save more lives. In line with this, the American Heart Association (AHA) have listed some of CPR techniques that can be used aside from the conventional CPR approach in an out-of-hospital and in-hospital cardiac arrest scenario.
CPR Techniques
High-frequency compression is a technique practiced to improve resuscitations for a cardiac arrest. In this method, the compressions given on a victim must be at least 100 to 120 per minute. Clinical trials that have been conducted shows improved hemodynamics, that is the circulation of blood in the body, when high-frequency compressions are used compared to conventional chest compressions. It is important to note however, that there is still insufficient evidence to recommend daily use of this.
In an open-chest CPR, on the other hand, an incision is made into the chest (thoracotomy) to perform CPR directly against the sternum commonly known as the breastbone. This technique however, is highly recommended when a cardiac arrest happens during a surgery when the chest or abdomen of the patient is already open. Although in a very select scenario of out-of-hospital cardiac arrest in adults and children with penetrating trauma, this technique can be considered. Noteworthy to be considered, some cases where open-chest CPR and thoracotomy is performed, survivors have experienced minimal even zero neurological deficit.
Another CPR technique involves the simultaneous practice of abdominal compression, chest compression and ventilations. This technique is called the interposed abdominal compression (IAC-CPR). In this procedure, there will be three rescuers who would attend to a single cardiac arrest patient. The dedicated rescuer will provide manual abdominal compression during the relaxation phase of chest compression. The quality—hand position, depth, rhythm and rate—of abdominal compressions is the same as the one required for chest compression. This technique is commonly administered during an in-hospital cardiac arrest occurrence with satisfactory results of “improved coronary perfusion pressure and blood flow to other vital organs” in most reports. One limitation of this technique is that it still remains to be proven whether or not it should be done in an out-of-hospital setting.
Prone CPR, just like IAC-CPR, is a technique that is highly recommended for hospitalized patients where an advanced airway is easily accessible. The general knowledge in administering CPR is to move the patient to a supine position; however, there are isolated cases wherein a patient cannot be placed in such and is placed in a prone position instead.
There are also some cases when a cardiac arrest patient is awake and conscious so he can be “instructed” on using Cough CPR. As the name implies, a patient suffering from an anticipated cardiac arrest (an arrhythmic cardiac arrest under a catheterization laboratory) is coached to forcefully cough every 1 to 3 seconds. Now, it is important to note that this scenario is supervised and happens in a controlled environment and can only be done when a patient is responsive. Technically, it cannot be taught to lay rescuers.
All of these techniques have been recognized by AHA; however, there are still studies and tests that need to be done to test their effectiveness on increasing the survival rate of a cardiac arrest patient in both in-hospital and out-of-hospital setup. There is one general knowledge though, that still remains to be true and that is CPR saves lives. This fact is enough to encourage everyone to learn how to administer CPR properly and you can do so by undergoing training by Citywide CPR.
