There’s a reason you need to get your CPR certification renewed every two years—CPR guidelines and best practices change all the time. As we learn more about the human body and as science advances, the American Heart Associate (AHA) rereviews CPR practices every five years to determine if they’re still the best way to administer life-saving care.

Knowing the history of CPR is as important as it is interesting. If you find yourself in a situation where you need to give CPR, it’s best to make sure you’re not using any outdated practices in order to give the victim the best chance of survival.

Before CPR

Before CPR was developed, early methods of resuscitation were, well, interesting, to say the least. They included:

• Placing something hot—ashes, water, burning animal feces—on the victim’s chest in hopes of warming them and restarting their heart
• Whipping the victim with nettles or wet rags to stimulate a breathing response
• Stringing the victim upside down by their ankles, then raising and lowering them to try and push air in and out of their lungs
• Laying the victim on a large barrel and rolling it back and forth to similarly force air in and out

The first iteration for what we now know as CPR was officially developed in 1960, though mouth-to-mouth resuscitation potentially dates over 200 years back. However, even after we stopped burying victims in snow or draping them over the backs of trotting horses to resuscitate them, CPR still went through some major changes to bring it up to speed with what we know it as today.

Emphasis of Chest Compressions Over Rescue Breathing

For those not professionally trained in CPR, the AHA has updated general CPR guidelines to emphasize chest compressions over rescue breathing. This isn’t to say rescue breaths aren’t important, but for those not trained in CPR, the inclusion of rescue breaths in general guidelines can make bystanders less willing to provide CPR. In addition to the complexity of remembering rescue breaths when compared to hands-only CPR, mouth-to-mouth also carries the risk of passing diseases from the victim to the CPR provider, another cause for hesitation.

Best Practices for Chest Compressions

In addition to an increased emphasis on chest compressions in general, the guidelines for the speed and pressure of compressions have changed over time. Bystanders are now encouraged to press harder, compressing the chest 2 to 2.4 inches deep on an adult. This is frightening for many who fear they might break the victim’s ribs or crack their sternum but remember—attempting to save the victim’s life is more important than causing temporary harm during CPR.

As for the speed of compressions, they’ve gotten faster over the years, from 60 a minute, to 100, to the standard guideline of 115-120.

Emphasis on Faster Response

Previous guidelines for CPR called for a bystander to “look, listen, and feel” for signs of life to assess a victim’s need for CPR—no longer. It’s also recommended bystanders don’t check for a pulse. Seconds count when providing CPR and pausing to determine whether or not the victim is breathing can waste precious moments that could be spent providing compressions.

Learn more about best practices for CPR and first aid on the Specialized Health and Safety blog, or schedule a class time to receive or renew your CPR certification.