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Hands-Only CPR: A Lifesaving Skill in Your Hands

Author :Glenhael Carolus

Date: 17 April 2025

Sudden cardiac arrest (SCA) a life-threatening medical emergency, where the heart suddenly stops beating. This leads to rapid loss of consciousness and cessation of breathing. In South Africa, like many other countries, a significant number of people experience SCA outside of a hospital setting. To further compound the problem, a notable proportion do not receive bystander CPR, which contributes to poor survival rates. In My professional experience as a Paramedic, in particular the Western Cape, witnessing bystander CPR is extremely rare.

Hands-Only CPR a simplified yet highly effective method, has been shown to at least double a person's chance of survival (American Heart Association). Both the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) recommends that bystanders can therefore solely focus on providing chest compressions.

How to Help ?

The procedure involves these essential steps:

1. Call for help: Immediately dial emergency services. (112 or 10177)

2. Position the person: On a flat firm surface, position the victim on his/her back.

3. Chest compressions: Place the heel of one hand in the centre of the chest. Place your other hand on top, interlocking your fingers. Push hard and fast in the centre of the chest at a rate of 100-120 compressions per minute.

Why to Help ?

I have to underscore the “importance of bystander CPR”. Evidence, including research within a South African context, demonstrates that initiating CPR, particularly within the first few minutes of cardiac arrest, is crucial [1].

Performing CPR early, helps to maintain blood flow to the brain and heart, significantly improving the likelihood of successful resuscitation and reducing the risk of long-term complications. Studies have shown that survival rates from out-of-hospital cardiac arrest are significantly higher when bystanders initiate CPR before the arrival of emergency medical services [2,3].

Fundamentally, Hands-Only CPR is easy to learn and empowers individuals to act confidently and effectively in a life-threatening situation. By removing the need to provide artificial ventilations. This method encourages more bystanders to intervene and contribute to saving more lives.

A Reluctance to perform CPR

Literature describes several factors that may contribute to the reluctance of performing CPR such as:

• Lack of PPE/barrier devices: There may be a hesitation to perform CPR due to concerns regarding disease transmission, lack of personal protective equipment (PPE) or barrier devices [4,5].

• Fear of causing harm: Individuals may worry about performing CPR incorrectly and causing further injury [6].

• Lack of confidence: A high stress situation may affect confidence and add to the complexity of initiating bystander CPR.

• Deterioration of CPR proficiency: Studies have shown that CPR skills and knowledge decline rapidly after training. This decline can begin as early as a few months after training, leading to a decrease in the quality of CPR provided [7,8]. The decay in proficiency highlights the importance of regular refresher courses to maintain competency and ensure effective CPR delivery.

There factors may actually be addressed by learning how to provide Hands Only CPR through effective training. Additionally, community training initiatives are crucial to increasing bystander CPR rates and improving outcomes for SCA victims.

Read more about our efforts to help improve bystander CPR.

I hope that you have gained a little more knowledge concerning bystander CPR and its importance. If you like to find out more what we offer don’t hesitate to reach out.

Read more about our efforts to help increase bystander CPR

https://www.georgeherald.com/News/Article/Local-News/20-minutes-training-could-save-a-life-202307271235 

References

1. Stassen W, Wylie C, Djärv T, Wallis LA. Out-of-hospital cardiac arrests in the city of Cape Town, South Africa: A retrospective, descriptive analysis of prehospital patient records. BMJ open [Internet]. 2021 Aug 9 [cited 2024 Apr 17];11(8):e049141. Available from: https://bmjopen.bmj.com/content/11/8/e049141

2. Bobrow BJ, Clark LL, Ewy GA, Chikani G, Begay S, Mullins J, et al. Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. Jama. 2008 Apr 9;299(13):1585-91.

3. Sasson C, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review. Circulation: Cardiovascular Quality and Outcomes. 2010 Jan;3(1):63-81.

4. Carcillo JA, Fields M, Lacroix J, Kwok MY, Kissoon N. Global variability in pediatric cardiopulmonary resuscitation practices during the COVID-19 pandemic: a survey of PICU and emergency department healthcare workers. Critical care. 2021 Dec;25(1):1-13.

5. Epstein L, Chapman SA, тран НТХ, Nadkarni VM. Recommendations and rationale for chest compression-only cardiopulmonary resuscitation in suspected coronavirus disease 2019. JAMA pediatrics. 2020 Jun 1;174(6):535-6.

6. AHA. Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation. Circulation. 2007 Nov 20;116(21):2451-5.

7. Custer JW, Wallace AB, Unger S, Currie LM. Cardiopulmonary resuscitation (CPR) competency retention among registered nurses in critical care versus general care unit. medRxiv. 2023 Oct 16.

8. Smith KK, Gilcreast DM, Pierce JR. Evaluation of the retention of basic cardiopulmonary resuscitation skills by healthcare providers. Critical care medicine. 2008 Dec;36(12):3231-8.