CPR Alone May be Better for Many Victims of Cardiac Arrest

A leading expert in cardiopulmonary resuscitation says two new studies from U.S. and European researchers support the case for dropping mouth-to-mouth, or rescue breathing by bystanders and using “hands-only” chest compressions during the life-saving practice, better known as CPR.

The findings, the expert says, concur with the latest science advisory statement from the American Heart Association, published in 2008, recommending hands-only (or compression-only) CPR by bystanders who are not adequately trained or who feel uncomfortable with performing rescue breathing on other adults who collapse from sudden cardiac arrest.

In an editorial accompanying the studies, to be published online in The New England Journal of Medicine, cardiologist Myron Weisfeldt, MD, physician in chief at The Johns Hopkins Hospital and director of the department of medicine at Hopkins’ School of Medicine, says “less may be better” in CPR, calling the findings straightforward, practical and potentially life-saving.

The two studies were conducted between 2004 and 2009 on more than 3,000 men and women who needed CPR. Among their key findings are that survival rates were similar for adults who received their CPR from bystanders randomly assigned to provide only chest compressions and those who were instructed to do standard CPR with rescue breathing. All bystanders involved in the studies were instructed by phone on which CPR method to use by 911 telephone dispatchers. One study showed survival rates after one month of 8.7% and 7%, respectively, while the other showed survival rates at time of hospital discharge of 12.5% and 11%. The researchers say the numbers were statistically the same.

“It is very important to understand that the patients in this study were adults and that for most children who suffer cardiac arrest, such as drowning victims, we must do rescue breathing,” says Weisfeldt.

He also notes that there are adults with breathing-related causes of sudden death where rescue breathing should be performed, including patients with sudden, acute heart failure, severe chronic lung disease, or acute asthma, and cardiac arrest.

However, says Weisfeldt, “for people who are not well trained or who are looking for a simple way to help save a life, chest compressions only, at least until the emergency care unit arrives, can be life saving, even without rescue breathing.”

Source: Johns Hopkins Medicine