Your in a life or death situation. The person you are with has stopped breathing. What do you do? You can't seem to remember what you have learned in a CPR class many years ago. Is it airway first? Compressions first? I don't want to lose this person. What do I do?

For years, anyone learning CPR -- emergency resuscitation -- was taught the "ABC": Check the airway for blockages, give breaths, then circulate the blood. New guidelines issued by the American Heart Association turn that alphabet on its head, punctuating a shift that has led emergency responders to emphasize compression of the chest over all else when treating victims of cardiac arrest.

The new catch-phrase is "C-A-B" -- as in start pushing on the chest before doing anything else. The AHA guidelines also uphold a 2008 recommendation that untrained responders call 911 but then forget rescue breathing completely, and simply press on the victim's chest until help arrives.

Going a step beyond that, the 2010 guidelines "strongly recommend" that 911 dispatchers guide callers in "compression-only" CPR, sometimes known as CCR. However, medical professionals and trained lay people are still urged to give the victim two "rescue breaths" in between each series of 30 chest compressions.

All the changes apply only to adult victims who collapse of cardiac arrest; artificial respiration is still recommended for children and for adults in a few cases, including near-drowning and drug overdose.

The science behind the changes is simple. In an adult who has been breathing normally, for several minutes even after cardiac arrest there is enough oxygen in the bloodstream to maintain the heart and brain, as long as compressions circulate that oxygen.

The new guidelines also call for faster and more forceful compressions than in the past. The new standard is to compress the chest at least two inches on each push, at a rate of 100 compressions per minute.

Dr. Ben Bobrow, who also helped write the new AHA guidelines, says the controversy should not be overblown.

"The difference between the specific types of CPR isn't nearly as large as the difference between not doing CPR, and getting people to do any kind of CPR at all," says Bobrow.

Indeed. It's all about those compressions. You have about 4 minutes before brain damage occurs. Use your time wisely. Save a life....

For more information on heart health here in Palm Beach, from the American Heart Association, the following link will give you all the resources you'll need: http://www.heart.org/HEARTORG/

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