The 911

Well, answer these questions for me: Are you tired of spending 3-5 hours on a weekday evening or Saturday learning CPR & First Aid when you have been through the same class for the last 10 years? Do you have internet access? Would you rather spend a few hours at home, in your comfy PJs, reviewing the content portion of the course and then schedule a short 30-60 minutes classroom session for skills evaluation? Then, online CPR training IS for you! Or, more accurately, “blended training” is for you!

What is the difference between “online training” and “blended training”? Simply put, “online training” usually refers to CPR training that’s 100% online based. If you type ”online cpr training” in a Google search you will see a few companies offering this at the top of the listings. Before you purchase their course, be sure to read their requirements for receiving a certification card. If they do not require you to complete an in-person skills test, then stay away! (Or keep looking down the list until you see the link for www.mycprpros.com. ;-)) Why? Because many employers and regulatory agencies (including the NC Dept. of Child Development) will not recognize certifications offered through 100% online courses that do not require in-person skills testing with a CPR instructor. This is a fact that many of these companies that offer CPR training online recognize. For example, here are actual samples of the “small print” on some of the top listed sites:

Sample #1

“This Site nor any party involved in creating, producing, or delivering this Site or its content, is associated or affiliated with, nor endorsed by American Red Cross or The American Heart Association. Our course is not designed to serve as a substitute for an inperson hands-on class conducted and/or supervised by a qualified instructor.”

Sample #2

“The certificate does not represent, warrant or guaranty that the purchaser is properly prepared or equipped to perform CPR, First Aid, or AED assistance. [Company’s name] role is to provide education to the student using generally accepted scientific guidelines. [Company’s name] does not represent, warrant or guaranty, either explicitly or implicitly, that its certification will comply with the user’s or any third party’s requirements or standards.“

Now, to be fair, most of these companies do offer a refund if you find that their certification is not accepted by your employer or regulatory agency. However, doesn’t having to contact this company, request and wait for a refund, and in the meantime schedule yourself for another CPR course, sort of defeat the purpose of taking online training in the first place - convenience? So, what does all of this mean? Are you back to wasting another weekday evening or Saturday? Absolutely not! Online CPR training is not something to be avoided; online training is something that should be purchased carefully. Make sure you choose a course that provides both online training AND and in-person skills evaluation, also called “blended training”. In part 2 of this series I will discuss the differences and benefits of “blended training”, which is the type of online CPR training MyCPRPros offers.

Here is an interesting news story I found this morning on CNN.com. It is reported that a dog named Toby saved his owner’s life when she was choking. The owner, Debbie Parkhurst, of Calvery, Maryland says that she was choking on an apple when her furry rescuer pulled her to the ground and began jumping on her chest. And with a few thrusts of the paws the obstructing apple bit was launched skyward.

I am not making this up, check ou the video news story on CNN.com

Oh, I fortgot to mention that we were unable to independently verify this story, since, well…Toby ate the apple projectile. Additionally, our calls to identify the offending apple variety were not returned.

If you were following the news last week you no doubt saw or read a story about a study in Japan that showed that permanent brain damage was less likely when victims of cardiac arrest were give compression only CPR (also called cardio-cerebral resuscitation or CCR) as opposed to those receiving traditional CPR (compressions and ventilations). This study was published in a recent issue of the medical journal The Lancet. In the study, researchers examined the post event neurological function of 4,068 patients who had been victims of witnessed cardiac arrest. The results showed healthy neurological function in 22% of those receiving compression only CPR compared with 10% of those receiving compressions along with ventilations.

This finding is in no way breaking news. In fact, the current study, and the media attention surrounding it are just a recent splash of lighter fluid on a decade old pile of glowing scientific embers. I haven’t had the time (nor interest to be honest) to find out when this debate began, however, I am aware that even as far back as October 1993 the magazine Circulation published studies on this topic. So, the debate rages on.

Which CPR method should be advocated? That is not a simple answer. In actuality, it depends on the person performing CPR, and the person it’s being performed on. Let me illustrate. If a fuel pump stops functioning properly in your car it needs to be replaced in order for a continued supply of fuel to be delivered to the the engine. However, if there is no fuel in the gas tank, replacing the pump in itself will be of no benefit. Likewise, when the human heart is out of normal rhythm its function must be replaced, in this case by manual contraction of the heart by means of chest compressions. Manual compression provided as quickly as possible will insure the best possible distribution of fuel, in this case oxygen carried in the blood, to the engine, the heart and brain. However, if there is no fuel (oxygen) in the system, replacing the pump (manual contractions of the heart) will be of little to no benefit.

So, in cases where there is still an adequate supply of oxygen in the blood, as in the case of a witnessed collapse from cardiac arrest, some recent reports have shown that compression only CPR results in significantly better survival rates. An additional time when compression only CPR can be beneficial is when a rescuer is hesitant to provide traditional CPR, either due to lack of knowledge, or due to concerns about communicable diseases. However, in the case where there is the potential for a significantly diminished levels of oxygen in the blood, as in the case of unwitnessed cardiac arrest, and cardiac arrest caused by chocking, drowning, or respiratory issues (as is often the case with infants and children) traditional CPR will most likely provided the greatest benefit to the patient. So then, there really is no one-size-fits-all resolution to this debate. It will be interesting see what evidence future studies bring to the table and how CPR training guidelines are affected by these. We will just have to wait and see.

You may find the following links related to this topic to be of interest:

American Heart Association Compression Only CPR Worksheet

PubMed Directory Listing of Compression Only CPR Articles