CPR Misconceptions. The following 4 points are incorrect, absurd or half truths. Written by TTM 1) It’s compression only CPR now – incorrect 2) We will get a gas exchange with compressions only – incorrect 3) If you’re not breaking their ribs, you’re not doing it right – absurd 4) CPR saves lives – half truth If you agree with any of these points based on your training you should seriously reconsider your trainer. How many times over the years have I heard participants say, “Its compression or hands only CPR now.” 1) If you do not have a proper protective barrier and you choose not to do mouth to mouth, a decision born from the concern of contracting a disease, then yes compression only CPR is better than nothing, especially during the first few minutes. However, we need oxygen or we’ll die and stay dead without it. It takes approximately 4 minutes to de-oxygenate that’s why brain death starts to occur after 4-6 minutes. CPR stands for Cardio-Pulmonary Resuscitation. 2) Compressions move the blood through the body by external mechanical compression of heart, but without mouth to mouth (or a positive pressure ventilation system) there is no gas exchange in the lungs or Pulmonary system. Contrary to what some instructors believe, we are not providing a gas exchange with compressions only. I have heard from numerous participants that have received training elsewhere and they have had this misconception relayed to them. 3) To do CPR correctly are we suppose to break the ribs? – No! Breaking the ribs is not our goal. Will it happen? Yes, it can happen, more so in the elderly related to osteoporosis and cartilage degeneration. Are we actually breaking the ribs? Possibly, but more often what happens is dislocation of a rib or some ribs from the sternum or breast bone. Our true ribs span from our spinal column to our sternum attached by costal cartilage. With enough pressure applied to the sternum, as in a focused sternal compression done during CPR, the cartilage is disrupted and the rib with “pop” forward. You very well may hear the popping sound, feel the end of the bone poking into the palm of your hand and hear the grating sounds as you move the sternum back and forth past the end of this rib. Am I telling you this to gross you out? Of course not. I’m telling you this to prepare you. Any gross out you may feel by knowing this will be overcome by the adrenaline of the moment. Now you are prepared. Remember death is the ultimate degree of poor health – we can’t make it any worse! 4) To be quite frank CPR, by itself, is almost useless in saving a life. So why bother to learn it!??!… because that last statement is a half truth. In a pre-hospital setting, in the age group of 44 and over, approximately 75% of patients in cardiac arrest are actually in Ventricular Fibrillation. Ventricular Fibrillation (VF or V-Fib) is identified as the initial rhythm by emergency services personnel. Unfortunately the reality is if the patient is in V-Fib the ONLY way to get them back is with a defibrillator. You can do CPR till the cows come home and you will never get them back. CPR aids in keeping a patient, that is in V-Fib, oxygenated and viable until a defibrillator can be obtained and utilized. With children you have a much better chance of getting them back with CPR only. Children do not typically suffer from atherosclerosis or “hardening of the arteries” or any other coronary artery disorders. Two of the three top causes of death in a child are airway obstruction and drowning (another type of airway obstruction) if you can get the airway clear or remove them from the water and start CPR immediately you have a very good chance of getting them back with the CPR only, which contradicts my opening statement to this section. This is one of those times I love to be wrong!