No need to lock lips

Simplified resuscitation technique focuses on blood flow, not breathing

Cindy Weaver, RN, demonstrates hands-only CPR on a dummy at Enloe Conference Center.

Cindy Weaver, RN, demonstrates hands-only CPR on a dummy at Enloe Conference Center.

Photo by Howard Hardee

Hands-on learning:

Enloe nurse-educator Cindy Weaver will demonstrate the hands-only CPR technique Aug. 23, 1-3 p.m., at the Gateway Science Museum in Chico.

Up until a few years ago, cardiopulmonary resuscitation—CPR—was a complicated procedure. The person performing CPR on a heart attack victim needed to make sure the patient’s head was in the proper position for a clear airway, then move back and forth between pushing on the chest to stimulate the heart and blowing into the mouth while plugging the nose to force air into the lungs—no easy task.

Training took hours, and even then, those who completed the course sometimes hesitated in a crisis, while well-meaning bystanders often would get the technique wrong.

Amy Castelluccio, an emergency medical technician who works as education coordinator for Butte County Emergency Medical Services, recalls trying to talk people through the process during her time as a dispatcher, and also the all-too-common scene she’d find when arriving as a paramedic. Trying to describe by phone the proper position to adjust the patient’s head was enough of a challenge; then, when the ambulance would arrive, EMTs often would find the patient with a bloated abdomen—a telltale sign that the air blown into the mouth had gone into the stomach, not the lungs.

“Those were cases where people didn’t survive,” she said, “because they weren’t getting what they needed.”

In 2008, that all changed when the American Heart Association revolutionized resuscitation with a new approach.

It’s called hands-only CPR, and that’s exactly what it is. Rather than worry about breathing, the resuscitator focuses exclusively on chest compression to get the heart beating.

“All of us have plenty of oxygen in our bloodstream,” explained RN Cindy Weaver, education coordinator at Enloe Medical Center. “We don’t need to worry about the airway by opening up the airway and making sure we’ve got breaths. We just need to get that blood circulated.”

The technique is so basic, anyone can learn it in a few simple steps online (the AHA demonstrates it at or in a matter of minutes from a paramedic or nurse. Enloe has set up an instructional station at the Gateway Science Museum and conducted impromptu training at Chico State; plans include expanding to farmers’ markets.

“For the lay public to become involved, it has to be simple and has to be user-friendly,” Weaver said. “Nobody has to worry about mouth-to-mouth right away; you can just do compressions and add mouth-to-mouth if you want to.

“There definitely are more people getting involved.”

How does hands-only CPR work? Really, there are just two things to remember:

• Call 911.

• Repeatedly press on the chest.

The training is more detailed than that, but not much. Weaver gave the CN&R a fairly comprehensive crash course by phone.

“If you see someone on the ground, or if someone becomes unresponsive in front of you or slumps to the ground, you shake them and go, ‘Hey, hey, hey; are you OK?’ If they’re not OK, you point to somebody—‘You call 911!’—and you start compression.”

Place your hands at the center of the breastbone, and push hard and fast.

Don’t worry about a precise position: “There’s no magic [place] where your hands are other than in the middle of the chest.”

The ideal tempo is 100 compressions a minute. The AHA recommends using the beat of the Bee Gees classic “Stayin’ Alive” but also has a Spotify playlist of 100-beats-per-minute songs for those who dislike disco or don’t have that chestnut memorized.

Keep going until paramedics arrive.

That, in essence, is hands-only CPR, whether for members of the public or medical professionals.

“The full classes aren’t as complicated now,” Weaver said. “It makes more sense, even [to people] above the lay public, and they’re easier to follow.”

The AHA formally launched hands-only CPR in 2010 with the set of heart-health guidelines it updates every five years. The association found the compression-only technique to be just as effective as CPR with breaths in treating heart attack victims, and quick action counts: “Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival,” the AHA says, “but only 32 percent of cardiac arrest victims get CPR from a bystander.”

Weaver recommends gathering the family around the computer so kids can learn with their parents. Anyone can save a life if they know what to do, especially now that CPR has become elementary.

“Just don’t be afraid to give it a try,” Castelluccio said. “I think there’s a lot of fear about helping somebody, which is another reason why hands-only CPR has been considered to be so important.

“A lot of people, if they don’t know someone, they don’t want to put that mouth on that person, so in the past people have not intervened because it’s been always kind of drilled into your head that if you’re going to do CPR, you have to do compression and you have to do breathing.

“Now that we’re trying to get people to understand that hands-only CPR is OK to do, don’t be afraid to do it, because it does work.”