New Guidelines

The new AHA/ILCOR Guidelines were published in the Nov. 29 issue of Circulation. While reading them, I found myself going back to the landmark editorial "Cardiopulmonary resuscitation in the real world: when will the guidelines get the message?" (Sanders AB, Ewy GA; JAMA 2005;293(3):363-5). Apparently, not yet. They are edging slowly toward dropping mouth-to-mouth ventilation, but I guess it will be at least another five years (with the next major revision) before they manage to do it. The big change in basic CPR is the change in compression:ventilation ratio from 15:2 to 30:2. Also, the ratio is now the same for everyone but infants (actually, I had forgotten that it was different for adults and children before). Does anyone really believe that this change will make a significant difference in the frequency or quality of bystander CPR? Somewhere (I think in Currents in ECC) I read that the AHA has a goal of doubling the number of people trained in basic CPR by 2010. How? Do they think that people will flock to CPR courses now that they have to mouth-kiss a corpse only three times per minute instead of five or six times? More later on the flimsiness of the argument against no-ventilation CPR.