Michele and I have been teaching CPR to healthcare professionals and students since 1984. We have seen the development, improvement, and wide-spread acceptance of CPR education over these years. Despite these advances, we still hear many myths about CPR every time we teach a class. As healthcare professionals and students, we must not allow old information, nor the public’s misperceptions and fears about CPR, nor Hollywood’s unrealistic depiction of CPR, to affect our duty to provide high-quality CPR to our patients and to the public. Therefore, in order to help dispel these myths, I have created this list of the most common CPR myths that we hear the most often from the healthcare professionals and students that we teach every day.
Myth 1: CPR must include mouth-to-mouth breathing.
Wrong. Health professionals or first responders will initiate chest compressions immediately. The breaths should be done preferably with a bag mask, mouth to mask or mouth to mouth with a barrier device. If you do not know the patient, and do not feel comfortable putting your mouth on theirs, or do not have a CPR face-mask, just perform continuous chest compressions with no breathing until emergency services arrives.The American Heart Association has revised its recommendations and encouraged lay bystander rescuers to use “hands-only” CPR as an alternative to CPR with exchange of breaths.
Myth 2: CPR always works.
Wrong. Unfortunately, this is not true, and is a very common belief that has been perpetuated by Hollywood. The actual adult survival rate from out-of-hospital cardiac arrest is about 2% – 15%. Survival rates can increase up to 30% if an AED is used to deliver a shock. However, if the victim’s heart stops and no one starts CPR immediately – then the victim’s chance of survival is zero.
Myth 3: I could get sued if I administer CPR in the wrong way or make a mistake.
Wrong. We have not read of any lawsuits that have been brought against lay rescuers or healthcare professionals who attempt to provide CPR. Generally speaking, our legal system provides nationwide Good Samaritan protection, exempting anyone who renders emergency treatment with CPR in an effort to save someone’s life. This includes lay rescuers and healthcare professionals. Lawsuits are usually focused around health clubs or similar institutions that have certified CPR employees that did not have or use an AED at the time of a cardiac arrest. Generally, as long as lay rescuers and healthcare professionals do not waver too far from standard CPR procedure, they will most likely be protected.
Myth 4: We can become proficient in CPR with an on-line class.
Wrong. While it is true that you can learn the steps of CPR from an on-line class, you most likely would not be able to perform high-quality CPR on a real patient after taking a computer based CPR class. Hands-on practice, with the guidance of a certified instructor, is the key to developing muscle memory and proper techniques.
Myth 5: We can save a sudden cardiac arrest victim with CPR alone.
Wrong. An AED/defibrillator can deliver shocks that will return the fibrillating heart to its normal rhythm. CPR alone cannot revive a sudden cardiac arrest victim. CPR can only delay death until a defibrillator delivers a lifesaving shock.
Myth 6: A patient should cough while having a heart attack to prevent the heart attack from getting worse.
Wrong. This myth is what is known as ‘Cough CPR’. Cough CPR was thought to speed up a very slow heart rate (bradycardia) and keep the patient conscious till emergency services arrived. It is probably a mis-interpretation of the vagal maneuver. The vagal maneuver is used to help a patient stimulate the vagus nerve to slow down a fast heart rate.
Myth 7: Cardiac arrest is the same as a heart attack.
Wrong. They are different conditions and are treated differently. Cardiac arrest is caused by an arrhythmia, dysrhythmia, irregular heartbeat, which leads to cardiac standstill, where the heart is not moving (asystole) or is fibrillating (ventricular). A heart attack is a myocardial infarction, caused by a blocked coronary artery. Therefore, the term ‘cardiac arrest’ is not synonymous with ‘heart attack’. A patient experiencing a heart attack may experience chest pain, nausea, vomiting, and become diaphoretic. However, a heart attack may ultimately lead to cardiac arrest depending on the severity of the blockage in the heart.
Myth 8: Someone with more experience than me should help the victim. So I shouldn’t help.
Wrong. The key to surviving cardiac arrest is the immediate response of someone trained in CPR. A patient who collapses and does not immediately receive chest compressions has little or no chance of survival. If you know how to do chest compressions properly you should help immediately.
Myth 9: CPR can do more harm than good.
Wrong. When you are performing CPR it is on someone who has no heartbeat. Proper chest compressions, to be effective, must be fast and very hard. It is true that you may possibly break some of the victim’s ribs while performing CPR. Once a victim is resuscitated injuries can be treated. Damaged ribs are worth the risk and much better than letting the victim die without attempting to give CPR.
Myth 10: CPR will always re-start the victim’s heart if they are in asystole.
Wrong. CPR alone will not always re-start a heart that is not beating. The purpose of administering CPR is to push oxygenated blood to the victim’s brain and other vital organs. Continuing high-quality CPR will decrease the number of the victim’s brain cells that will die without proper blood flow. Medications such as epinephrine and vasopressin may assist in getting the blood flow back into the heart.
Kunz is currently certified by American Heart Association as being proficient in BLS, CPR, and AED since 1988. He is also an AHA Certified BLS, CPR, and AED instructor. He is also the co-founder and co-owner of a medical training company that provides AHA certification classes to healthcare professionals and students in the New York City Area.