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Guest Column by Honorable John Porter, of Washington D.C.
Former U.S. Congressman (Illinois), Vice-Chair of the Board of the National Institute of Health Foundation, and Board Member of the American Heart Association

We think of progress as something that signals a new beginning or change for the better.  Sometimes it occurs over a vast realm of time, such as the discovery in the 16th Century and 17th Century that the center of our universe was the Sun, not the Earth as ancient Greek scientists had believed.  Even then, when the renowned astronomer Nicholas Copernicus and the famed Italian scientist-inventor Galileo revealed this discovery, it took another century or two before the advent of powerful telescopes confirmed their findings.

That was considered progress.  In today’s American society, the wait of 100 years or more would not settle well with most people.  Fortunately, the time period between a medical discovery and the way it reaches the people has grown shorter.

I draw attention to last month’s announcement by the American Heart Association (AHA), concerning the way a significant life-sustaining first aid skill is taught.  On November 14, 2005, the association signaled a major change about how Cardiopulmonary Resuscitation or CPR is taught to millions of Americans eager to come forward and save the life of someone stricken by a heart attack, for instance.  AHA said in its findings that five minutes of defibrillator use and another 20 minutes in CPR instruction was just as effective as the standard four-hour course taught by instructors.

 “The more you have to remember, the more likely you are to forget,” according to the lead researcher, who presented the study.

This declaration confirmed the findings of two medical researchers of 1995 that CPR is better understand by young and old if the course is shorter than the standard, longer version now offered nationwide.  The researchers, Allan Braslow, now of Braslow Associates, Greenwich, CT, and Dr. Robert T. Brennan, now a child and health and social ecology researcher at Harvard Medical School, presented these findings before a medical conference in Montreal, Canada.  Joined by other medical professionals, their study appeared in Resuscitation a year later.

Their study concluded that older audiences thrived on a reduced time-span to learn basic CPR training.  They looked at a change where instruction would be more readily accessible and acceptable for learners of all ages, requiring less time than the standard four-hour course.

Video self-instruction, Drs. Braslow and Brennan proposed, was a better alternative than the traditional classroom teaching because it would achieve better CPR skill performance.  A half-hour training tape would be more organized and deliver the message to people, who need to feel more competent in saving lives.

Other pioneers in this life-supporting field felt the same way.  The late Dr. Peter Safar, who developed the CPR method in the 1960s, advocated a shorter training period to reach more people.   The national Save A Life Foundation (SALF), headquartered in Schiller Park, Illinois, is another; since the mid-1990s, SALF has been moving forward with their own abridged training method.  It involves basic instruction that utilizes certified CPR instructors and eliminates lengthy monologues.  Within the next few months, they plan to unveil this new training video as a pilot nationwide.

During my years of service as an Illinois congressman, I became very familiar with SALF’s stance about condensed CPR training.  They found that retention levels among children, adults and the elderly increase significantly, and more people learn in a shorter period of time.  These steps alone helped prepare people to respond quicker in aiding a heart attack victim. 

As someone who is intimately aware with SALF and AHA, this change toward shorter CPR instruction comes at a time when more and more Americans need to be aware of what to do in an emergency.  Certainly, the demands of time on an individual's lifestyle offer compelling reasons why we should shift in this direction.

More changes appear to be afoot in the realm of emergency medical response.  Already the American Heart Association has also announced that the level of CPR compressions should be 30 to two breathes, a departure from the normal standard of 15 compressions to 2 breathes. 
While this change in philosophy is laudable, it’s just the beginning of a new era.  We are not done yet. 

It should be no secret to anyone that at least 75 percent of all cardiac arrests occur at home.  Approximately 95 percent of sudden cardiac arrest victims die before reaching the hospital.  About 900 Americans die every day due to sudden cardiac arrest.

The next mission is reaching people.  The issue with CPR is whether people will do it.  That alone invites a series of questions.

Where do we go from here?  Will people come forward when someone suffers a heart attack or is found unconscious on the floor of a home?  Will they feel comfortable and be competent performing CPR?  There are not many studies available that identify the customs of society where intervention may not encourage help or aid. 

When training someone to perform CPR, we have to establish a level of competency and a comfort zone that will enable him or her to do it. That’s the next area where researchers must go and make more discoveries that hopefully will come even sooner than a decade to gain acceptance.