From Our 2010 Archives
Chest-Compression-Only CPR Saves More Lives
Researchers Say the Technique Has Advantages Over CPR That Includes Mouth-to-Mouth Resuscitation
By Denise Mann
Reviewed by Laura J. Martin, MD
Researchers found that adults who experienced cardiac arrest in a non-hospital setting, such as a restaurant or mall, were 60% more likely to survive if they received compression-only CPR than if they received traditional CPR or no CPR until an emergency medical services (EMS) crew arrived at the scene.
The findings are published in the Oct. 6 issue of The Journal of the American Medical Association.
The researchers say chest-compression-only CPR may be easier to learn and remember than traditional CPR, which alternates between chest compressions and mouth-to-mouth resuscitation. Non-medical personnel may be more willing to perform chest-compression-only CPR, as they may not want to do mouth-to-mouth resuscitation -- especially on strangers.
There may be additional benefits to this method as well. The survival edge may occur because interrupting chest compressions --- even just for rescue breathing-- may further hamper blood flow, and it takes longer to get that blood flow back when it is time for more chest compressions, explains study researcher Bentley J. Bobrow, MD, of the Arizona Department of Health Services in Phoenix.
The new study adds to a growing body of literature that supports the use of chest-compression-only CPR by bystanders during cardiac arrest. Guidelines due out later this year are expected to endorse this method as equal to, if not better than, traditional CPR for nonmedical bystanders, according to information in an accompanying editorial.
The new study looked at rates and types of CPR performed by lay people following a five-year statewide public education effort in Arizona that aimed to teach and encourage chest-compression-only CPR. Outreach included radio spots and interviews, inserts in utility bills, and free training in various settings.
The researchers analyzed outcomes among 4,415 adults who had cardiac arrest outside of a hospital and received either no CPR until EMS crews arrived, chest-compression-only CPR, or traditional CPR. Emergency personnel verified the type -- if any -- of CPR that was administered prior to their arrival.
Overall, 13.3% of those who received chest-compression-only CPR survived to hospital discharge compared with 7.8% of those who received traditional CPR, and 5.2% of those who received no CPR from bystanders, the study shows. What's more, the public health education strategy influenced the amount of people willing to provide any type of CPR, researchers report. The number of bystanders who performed chest-compression-only CPR instead of traditional CPR also increased during the study period.
The survival benefit seen in the new study was "modest," points out David C. Cone, MD, in an editorial published along with the study. Cone is an emergency room doctor at Yale University School of Medicine in New Haven, Conn.
But "this finding is important when considering that the survival rate from out-of-hospital cardiac arrest has remained dismally low despite decades of study," he writes.
SOURCES: Cone, D.C. Journal of the American Medical Association, Oct. 6, 2010; vol 13: pp 1493-1495.Bobrow, B.J. Journal of the American Medical Association, Oct. 6, 2010; vol 304: pp 1447-1454.