Am I misremembering this?
Posted by Queasy-Donut-4953@reddit | preppers | View on Reddit | 44 comments
I swear I learned in cpr class that before starting chest compressions for an infant or child you give 5 rescue breaths first, then 30 compressions and after 30 compressions you give 2 rescue breaths before alternating between the two methods (30:2 at a rate of 100:120.) Am I misremembering?
And for 2 person cpr it’s 15:2.
There_Are_No_Gods@reddit
The recommendations keep evolving, at least twice with big changes in counts since I took CPR training back in high school as part of lifeguard training.
Some of the more recent studies have even dropped rescue breathing entirely, with evidence showing that just doing the compressions was as effective. As more data is collected and studied, the guidelines adjust accordingly.
Divisible_by_0@reddit
Yeah my CPR class last year the guy said no more rescue breaths. Oddly though He was very against using tourniquets and when we left the class I looked at my coworkers who in with me and said f that guy if I go down with a massive bleed somehow, put my tq on or I'm gonna haunt you.
Hopeful_Still0008@reddit
I took a CERT class and the instructor mentioned no tourniquets for long term as it would cause more damage. I was shocked too when learning this.
Sharp_Ad_9431@reddit
CERT though is mostly mass trauma events. You don’t do a lot of helping. You do a lot of guiding people to help themselves. At least in the cert I went. Our scenarios were Help wasn’t coming for a long time, most first aid for severe injuries were useless because there was no hospital to go to. If the injury would need surgery or more care than what we could do for 24 hours, you were only wasting your time.
Divisible_by_0@reddit
Yes, there is a worry about the body compartmentalizing if a tq is left on for too long (the time frame of which also keeps changing I've heard from 2hr max to 24hr) there has also been some information as to it not being an issue at all but that type of stuff is waaay out of my field.
All I can say is if you don't put the tq on you will die or put it on and you might die. Be it in 6 hours or 40 years. For day to day I will always go for the tq because I will have an ambulance in 15 minutes. Which is the whole premise of the CPR class we took for work so I find it really odd to not advocate TQs
Bloodless10@reddit
If you don’t put a tourniquet on an arterial bleed you will die within minutes. If you do put one on, you might lose a limb after several hours. I’ve heard you can have a tourniquet on for 8 hours before causing permanent damage. Even if it’s 2, that’s 2 hours more you live than you otherwise would have.
Divisible_by_0@reddit
Exactly. Die now or maybe die latter 🤔
Sharp_Ad_9431@reddit
They worry that people will put tourniquets on minor injuries.
🤷🏼♂️ Maybe people don’t know what arterial bleeds would look like.
CattleDogCurmudgeon@reddit
This has never made sense to me. I carry a tourniquet in my glove box. In a traffic accident, an arterial bleed is the one thing that I can do to save your life. Just about everything else can wait for paramedics.
Plus, compartment syndrome takes at least 2 hours. If a tourniquet is misused, you have hours to remove it before long term damage is done.
Nufonewhodis4@reddit
the vast majority of tourniquets i see are unnecessary. the minority that were probably saved the person's life, and I have seen zero cases of nerve damage or compartment syndrome from one. VAST data from the US's experience during the Global War on Terror, Israel, and now Ukraine show that tourniquets and needle D/finger thoracostomy can and should be performed
CattleDogCurmudgeon@reddit
Yeah, I think the issue in Ukraine for the report I was looking at was that the tourniquet was being mis-applied and then the wounded wouldn't make it to an aid station for another 6+ hours. Not really an issue most of us have in our day to day lives.
Nufonewhodis4@reddit
those have been very rare. in a prolonged field care setting, they should be attempting to convert those to packing or pressure dressing.
but like you said, not an issue for most of us and the alternative is possibly bleeding out
AyeYoThisIsSoHard@reddit
I’d much rather take off an unneeded TQ than bleed out but that might just be me
samtresler@reddit
When appropriate a tourniquet is fine, but it isn't the first resort.
Also, and this is for anyone listening. If you have a tourniquet and know how to use it you also need a sharpie, tape you can write on, and a way to tell time in that same kit.
You label it as soon as bleeding is under control with the time it was applied, and each time you loosen it (if you don't know what I mean, take the tourniquet out of your kit until you get training).
Questionswithnotice@reddit
Apparently people weren't periodically loosening the tourniquet to allow blood flow, so they were doing more harm than good. Though I feel like that had more to do with snake bites than large bleeds.
Reptilian_Brain_420@reddit
If there is an arterial bleed that is severe enough for a tourniquet (i.e. not an artery in your thumb or something) then there isn't any circulation beyond the point of injury anyways. Releasing the tourniquet won't restore distal circulation, it will just cause you to bleed out faster. It is important to note when the tourniquet was applied so medical staff can have an idea if the tissue beyond it is likely to survive.
If you are applying a tourniquet you should probably assume you are going to lose everything after the tourniquet unless you can get to medical aid really quickly.
Divisible_by_0@reddit
I have an old 50s boy scout book that says something about TQs for snake bites and loosening it, but I think they have added TQs to the no go list for snake bites now as the venom just rots away the bite area weather or not you put a TQ on so there's no point in chancing the blood flow issues.
Reptilian_Brain_420@reddit
A "massive bleed" would be appropriate for a tourniquet. But, the number of times I've seen someone with a relatively small cut that could easily be controlled with direct pressure pull out a tourniquet with the intent of finally getting to use it blows my mind.
I cut my finger once in a kitchen and although it was a decent bleed, this idiot wanted to tourniquet my entire arm to control it. I told him that if he touched me with that thing I'd give him a reason to use it on himself.
They are useful and have their place. But, that place is not very common in the life of the average person. Most people tend to over use them.
mmaalex@reddit
CPR for the layman is just compressions, and has been for a decade, CPR for professionals has breaths. They found with the breaths being trained random people are reluctant to do anything, and two the breaths dont really do anything useful for the first 5 or so mins since your blood still has O2. By the time you need more O2 hopefully EMS is on scene.
The recommendations from AHA change every 5 years, as they have a big international conference. Next conference should be 2025, with training changes following around 2026.
I'm old enough to have been initially trained at 5:1...
Middle_Aged_Insomnia@reddit
Was going to say this but i checked to see if someone else said it first. You are right about the first five min. However, hands only cpr doesnt mean you cant do rescue breaths...just that you dont have to if you dont feel comfortable. Body substance isolation and all that. People didnt like idea of mouth to mouth. They still recommend it for infants, children, drug over doses, drownings and general respiratory issues. Unfortunately people are teaching it wrong and AHA needs to clarify this better. Many cpr inatructors out there have had no real healthcare experience. That really needs to change... as questions asked dont usually get answered right by many of them. Some experience should be required before you teach
adoradear@reddit
Don’t drop rescue breaths for kids. They disproportionately code due to hypoxia, vs ischemia in adults.
theloveburts@reddit
The AHA still recommends rescue breaths in certain situation, such as for infants, children, victims of drowning or drug overdose, or people who collapse due to breathing problems.
booksandrats@reddit
First aid is always changing and evolving over the years.
ohyeahwell@reddit
We did our CPR cert recently and I was surprised that there’s no breathing element anymore.
WhatYouLeaveBehind@reddit
Yes we do this in the UK. 5 initial for infants, 30:2 (even for 2 first aiders)
Similarly 5 initial for drowning victims.
scottd90@reddit
I follow Ellis guidelines at my job which is a little different:
Start with response check. Nothing? Call for help, then do a pulse/breathing check. Adult/child - carotid, infant - brachial artery
Yes pulse? No breathing? Start rescue breathing. Adult 1 breath every 6 seconds, child/infsnt 1:3 After 2 minutes (20 adult breaths, 40 infant/child) then reassess pulse/breathing.
No pulse? Go into CPR Alone? All, 30 compressions then 2 breaths. With someone else, child/infant go to 15 comp/2 breaths.
So in my training, no we do not do 5 breaths.
SparrowLikeBird@reddit
That is how it used to be taught. Currently, they no longer advise using any rescue breaths for children, as a child who has lost consciousness generally has an obstruction to their breathing, and it is more important to circulate existing blood oxygen than to blow on a choking hazard and maybe get your mouth vomited into
It is also generally accepted that if you are successful with compressions the breathing may restart on its own.
nwhiker91@reddit
Chest compressions 100% it went from 15/2 breath 30/2 now it’s just compression ( unless you are the medic or EMT) as a civilian just keep doing compressions you want that blood circulation to the brain. They got rid of breath for a few reasons one people are more comfortable with doing compressions and two people were giving breaths wrong causing aspiration and other problems. I would rather have someone doing good deep compressions on me at 100 beats a minute.
If you don’t know what you are doing 911 will talk you through it if you are in a time or place where there is no 911 just do compressions until you physically can’t or help arrives.
Starting good CPR should feel like crushing cereal with your palm good deep compressions constantly does save lives.
moonieass13@reddit
As someone who dispatches for ems. I can tell you our instructions are to still give breaths. But updated cpr classes are saying not to. Truth is, if you’re doing cpr.. you probably aren’t doing it effectively anyways so you’re better off to keep doing compressions than to stop and give breaths. Having said that, if you know what you’re doing and doing it effectively it can’t hurt.
Gruffal007@reddit
CPR changes as we get more data on best practices. it's why its important to keep up to date
TheseusOPL@reddit
For youth it's still recommended to give 2 breaths first because it's more likely for them to have heart issues because they stopped breathing. For teens and adults, it's more likely their heart stopped first so you skip that.
If you forget, anything is better than nothing. Their heart has stopped. They are dead. You can only make it better.
As far as compression only, it's great IF HELP IS CLOSE. If you're far out of town or camping, you'll need breaths too. There is enough oxygen in the blood for some time (10 minutes IIRC), but not for a long time.
DwarvenRedshirt@reddit
It's complicated. The requirements have changed multiple times over the years. I don't recall ever having been trained on 5 breaths first (it was 2 breaths). I do recall the 30:2 and 15:2 rate (for 2 people) from training years ago.
The current recommendations for the lay person is no rescue breaths since 2008. There was research that showed that blood circulation was a bigger deal than rescue breaths (and a lot of people were leery about giving rescue breaths and ended up not doing anything at all). That got a huge reinforcement in 2020 due to COVID (no one wanted to do rescue breaths for infected people). Professionals are still trained to do rescue breaths though.
I would note, this is all under the assumption that you have a working medical system and ambulances are on the way. If it's going to be a while, you should fit some rescue breaths in. But I think the reality is you're going to keel over from exhaustion before that becomes an issue. Doing constant chest compressions is not easy work.
Imagirl48@reddit
That’s what I learned in CERT training. They really pressed the point that giving compressions was very tiring and if other help wasn’t likely to be quickly available then we should move on to helping others who might be more easily saved. This was, of course, for situations when many people have been seriously injured.
DwarvenRedshirt@reddit
Yep, your time is much better spend on others in a disaster. Harsh as it may be, these people are already clinically dead, and the rate of survival WITH properly performed CPR in non-disaster situations is less than 10%.
AvatarOR@reddit
Rescue breathing is still recommended for trained medical personal.
https://avive.life/blog/why-is-mouth-to-mouth-no-longer-recommended/
cloudycerebrum@reddit
I can see the idea of 5 rescue breaths first, as most peds arrests are respiratory related, but I can’t recall this being taught. One thing that always throws me off is to start CPR on infants with a HR < 60. I get why but it seems counterintuitive.
Past-Lychee-9570@reddit
The most common cause of cardiac arrest in kids is hypoxia so rescue breaths are still recommended as of my class this year
Eredani@reddit
Yeah, this keeps changing all the time I can't keep up.
kaoticgirl@reddit
Not all the time, just as we learn better ways. And it doesn't matter if you keep up, just do the CPR you know. Hell, do the CPR you saw on TV
YYCADM21@reddit
The current standard is for no rescue breathing, However...Do SOMETHING. Even if your training is twenty years out of date, doing compressions the way you were taught is infinitely better than doing nothing while you try to determine the correct action.
Many years ago, I attended a "Female down, unresponsive" call at the airport. A 31 year old woman, 29 weeks pregnant, had suffered a seizure in the lavatory on an airplane. She fell forward, jammed herself head down in the lav corner, vomited, and aspirated it.
The crew had gotten her out, cleared her airway, and had her in a recovery position, however they were doing nothing else; FIVE people were standing around, debating what technique was appropriate for someone visibly pregnant. The patient had been down for at least 8 minutes on arrival.
CPR was started, defibrillator applied twice. She did not survive. Autopsy determined no cardiac defect of any kind; she suffocated. If any one of those people had simply done chest compressions, she would very likely have survived, as would her child. I will NEVER forget her husbands anguish when we got to her, pleading "Please, someone help her!!!)
jjgonz8band@reddit
No rescue breaths, 30 compressions 2 breaths, 100-120 compressions per minute
Infant: compress to 1.5 in - only compress using thumbs
Child: compress at most 2 in - use typical palm placement
Adult: compress at least 2 in - use typical palm placement
Rescue breaths are for people suspected of drowning, 2 rescue breaths before CPR
I just completed the CPR portion of first aid training today.
Queasy-Donut-4953@reddit (OP)
Thank you!
Shoddy-Ingenuity7056@reddit
And if you get confused compressions only are better than nothing.
Hopeful_Still0008@reddit
It’s 30 chest compressions to 2 rescue breaths for a single rescuer. If there are two rescuers, the ratio is 15:2. I honestly haven’t heard giving 5 breaths first. CPR techniques have changed a tad bit over the years though.