The new 2005 Guidelines admit that no-ventilation CPR is probably fine for the first few minutes after witnessed sudden collapse, but it is not recommended because teaching lay rescuers different sequences would be too confusing:
http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-206
In another section, the Guidelines instruct healthcare providers to make just such a determination and to tailor their actions accordingly (call first vs. CPR first), but neglect to mention that in response to witnessed sudden collapse no-ventilation CPR is a perfectly acceptable option. There seems to be an inconsistency here. If healthcare providers can determine whether an arrest is primarily asphyxial or cardiac, why can't they then perform (or not) MTM ventilation?
I've been thinking recently about the resistance of the AHA conference participants (or "experts," in the preferred terminology of the Guidelines) to no-ventilation CPR. If no-ventilation CPR were accepted as a first-line response, what would be the consequences for the AHA's Emergency Cardiac Care (ECC) Programs? What if CPR could be taught effectively in a 30-second or one-minute public service announcement (PSA)? I believe that would mean the end of ECC Programs.
My understanding is that ECC Programs are self-supporting (I believe that is unique within the AHA). That is, it does not receive any money from the charitable contributions to the AHA. In addition, ECC Programs are expected to generate revenue for the AHA, primarily through sale of its training materials and fees for its training programs (in recent years, this has taken the form of licensing fees from regional training centers). It seems clear that much of this revenue would dry up, and ECC Programs would have problems sustaining itself, if Basic Life Support classes were no longer necessary (e.g., if BLS could be taught by a PSA).
Is there an institutional conflict of interest here?
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