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Over the last half century, tens of millions of people have received CPR by the old method of giving mouth-to-mouth resuscitation and compressions on the chest. It turns out that far more people survive with chest compressions alone.

Dr. Alson Inaba, a professor of pediatric medicine at the University of Hawaii, is one of the unsung heroes of American healthcare. It was Dr. Inaba, flying home to Hawaii from a conference on heart health, who first realized that giving cardiopulmonary resuscitation to the beat of the Bee Gee's song Stayin' Alive was the perfect way for first responders, EMTs, and trained bystanders to give first aid to victims of cardiac arrest.

This popular song from the 1970's has a rhythm of 103 beats per minute. The American Heart Association recommends that manual chest compressions for sudden death victims should be given at 100 beats per minute.

Humming this Bee Gees hit gives the right rhythm for saving lives--and the new method of CPR dos not require any icky mouth-to-mouth contact. But to understand what the Bee Gees, chest compressions, and mouth-to-mouth resuscitation have to do with saving lives, it is probably helpful first to understand what was wrong with the old CPR what's new about the new CPR.

What Was Wrong with the Old CPR?

Most of us have seen demonstrations of the older method of giving cardiopulmonary resuscitation to people who are not breathing at all or who are only breathing with "agonal," gasping breaths. First the person giving emergency aid makes sure that the victim's breathing passages are open. Airways have to be clear for victims to have any chance of breathing on their own.

Then, in the old method of CPR, the first responder presses down on the victim's chest to a depth of 5 cm (about 2 inches) 5 times, pinches the victim's nose shut, and breathes into the victim's mouth. Then the process is repeated, 5 compressions, one breath, 5 compressions, one breath, until the person is brought to a hospital.

The problem with the old method was, despite what you may have seen on television or in the movies, it almost never worked. Fewer than 2% of people who suffered "sudden death" from irregular heart rhythms and received CPR outside the hospital could be brought back to life. (The figure is substantially higher for people who stop breathing because of drowning.) And up to 2/3 of that 2% of who lived suffered permanent disability due to brain damage.

What's New About the New CPR?

Since 2005, both the American Red Cross and the American Heart Association have been recommending a different way of doing CPR. The new method relies on chest compressions alone. Instead of a relatively deep compression once a second, the new CPR requires a shallow compression, only to a depth of 2 cm (about 1 inch), but 100 times a minute instead of 60. And in the new CPR, no mouth-to-mouth resuscitation is required.

Emergency medical specialists realized that when CPR is used, it is usually because a bystander observed sudden death. In the one to two minutes after the heart suddenly stops, the blood still carries oxygen. It is more important to keep that oxygen-rich blood circulating than it is to stop to try to force more air into the lungs. And if the givers of emergency aid can keep up the muscle compressions--it becomes very tiring very quickly for the first responder--in far more cases the victim can be kept alive long enough to get medical intervention, such as oxygen, intubation, and electrical shock to defibrillate and restart the heart.

This new method of CPR brings the save rate for people who suffer sudden death outside the hospital to about 10%. But in the hospital, or when the ambulance comes very quickly, the rate of survival jumps to about 70%.

Everyone should learn how to give the new CPR. There is almost no risk of catching a disease by giving the new CPR. You won't have your mouth on their mouth when they start gasping for air (if CPR is successful). There are certain other unpleasant events that may happen, but won't happen into your mouth. And the new CPR is very easy to learn.

Continue reading after recommendations

  • Herlitz J, Svensson L, Holmberg S, Angquist K, Young M. Efficacy of bystander CPR: Intervention by lay people and by health care professionals. Resuscitation. 2005. 66:291–295. doi: 10.1016/j.resuscitation.2005.04.003.
  • Trowbridge C, Parekh JN, Ricard MD, Potts J, Patrickson WC, Cason CL. A randomized cross-over study of the quality of cardiopulmonary resuscitation among females performing 30:2 and hands-only cardiopulmonary resuscitation. BMC Nurs. 2009 Jul 7. 8:6. doi: 10.1186/1472-6955-8-6.
  • Photo courtesy of ozarksredcross on Flickr: www.flickr.com/photos/ozarksredcross/4352081361
  • Photo courtesy of leppre on Flickr: www.flickr.com/photos/leppre/2502570443

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