Compression-only cardiopulmonary resuscitation beats standard CPR

[alienlovechild 75]

Cardiopulmonary resuscitation or CPR indicated to revive or keep alive patients who experience cardiac arrest or cardiac infarction (heart attack) conventionally consists of two parts, chest compression and mouth-to-mouth rescue-breathing. But two studies confirm that the rescue-breathing part does not help.

The standard or recommended CPR includes 30 chest compressions and two mouth-to- mouth breaths. Chest compression requires pressing the patient's chest down at least one and a half inches within less than one second before releasing.

One study of about 2000 patients led by Thomas D. Rea, M.D. at the University of Washington and colleagues showed that chest compression only cardiopulmonary resuscitation saved 12.5% of patients who were able to live to hospital discharge after being resuscitated while the conventional CPR saved 11%. The study was published in the July 29, 2010 issue of the New England Journal of Medicine.

In the same issue, another study led by Leif Svensson, M.D., Ph.D. at Karolinska Institutet in Sweden and colleagues also found that chest compression alone helped 8.7% of patients to survive for 30 days or more while the standard CPR helped just 7% of patients.

Cardiopulmonary resuscitation is intended to create a type of artificial respiration to keep the patient alive while waiting for medical processionals to arrive.

A Japanese study reported on March 17, 2007 in The Lancet revealed that the so-called rescue breathing can actually do more harm than good, potentially increasing the risk of brain damage in the survivors.

Among more than 70 patients, the researchers found the percentage surviving with a favorable neurological outcome to be 19.4 percent among those receiving chest compressions without mouth-to-mouth ventilation.

In contrast, the favorable neurological survival rate in those who received traditional or recommended CPR was only 11.2 percent.

Experts explained that time is critical when it comes to the rescuing of a patient who suffers cardiac arrest. Mouth-to-mouth ventilation is not only unnecessary in those who suffer cardiac arrest, but also wastes time and disrupts chest compression, which should be continuous to increase the odds of survival.

http://www.foodconsumer.org/newsite/Non-food/Miscellaneous/compression-only_cardiopulmonary_resuscitation_2907100617.html

[john & jean 37]

the old standard still applies for drowning victims

[one...two...tree 2,762]

I saw a report on this last night. I've got a CPR class later next week with the AHA, so I'm wondering if these findings will change the training?

[john & jean 37]

I saw a report on this last night. I've got a CPR class later next week with the AHA, so I'm wondering if these findings will change the training?

probably not. will take awhile to be evaluated, and approved by the certification agency...

edit to add:

may never be adopted by the RED CROSS. past histroy indicates, they train to a higher standard...

Edited July 29, 2010 by john & jean

[HeatDeath 430]

Not necessarily. I took CPR at the last school I worked at 2 years ago in Canada and they were already saying this.

Apparently it takes a good 30-45 seconds of continuous compressions to get enough good blood circulation going that it actually moves new blood with relatively fresh oxygen into the brain, and if you stop the compressions to do a breath the circulation stops and you have to start all over again, so most people doing compressions the old fashioned way never built up enough head of steam to do any real good. There is apparently enough residual oxygen in the blood that, in the timeframe between when you start doing CPR and when the paramedics arrive, adding new oxygen to the blood during rescue breaths is not nearly as important as keeping the blood moving.

The ideal, of course, is for rescue breaths and compressions to occur simultaneously - that is why you always see professional paramedics working as a team when they do CPT after they arrive and takeover. But until they get there, continuous compressions do much more good than pausing every so often for breaths. If you really want to pause for breaths, do it no more than once every 2-3 minutes.

With drowning victims you need to get the airway clear, and probably several rescue breaths to start with, since they won't have the residual oxygen in their blood that a heart attack victim will, having used it up already. But even with them, the ideal interval between breaths is probably substantially longer than is usually practiced.

The good news is, in Canada anyways, that you cannot be held legally liable for any inadvertent damage you do to a person during CPR. Legally, they were dead already, so every little bit helps. Even if you screwed up the CPR completely and broke several of their bones, they're still better off than if you hadn't tried.

[HeatDeath 430]

probably not. will take awhile to be evaluated, and approved by the certification agency...

edit to add:

may never be adopted by the RED CROSS. past histroy indicates, they train to a higher standard...

Not necessarily. I was trained this way 2 years ago in Canada.

I was told the biggest problem the Red Cross had found with CPR was that everyone who had been trained, unless it was very fresh in their minds, was afraid to even try it, because they couldn't remember the breaths/compressions ratios and were afraid of legal consequences should they screw it up. We were told the new standard was to train compressions-only CPR because it works at least as well, if not better [see above], and is way easier to remember. We were also assured, under Canadian law anyways, that the legal risk in attempting CPR is basically nil - that no matter how badly you screw it up, the person is still better off that you tried, and that there is no legal grounds for anyone to sue.

[one...two...tree 2,762]

Not necessarily. I took CPR at the last school I worked at 2 years ago in Canada and they were already saying this.

Apparently it takes a good 30-45 seconds of continuous compressions to get enough good blood circulation going that it actually moves new blood with relatively fresh oxygen into the brain, and if you stop the compressions to do a breath the circulation stops and you have to start all over again, so most people doing compressions the old fashioned way never built up enough head of steam to do any real good. There is apparently enough residual oxygen in the blood that, in the timeframe between when you start doing CPR and when the paramedics arrive, adding new oxygen to the blood during rescue breaths is not nearly as important as keeping the blood moving.

The ideal, of course, is for rescue breaths and compressions to occur simultaneously - that is why you always see professional paramedics working as a team when they do CPT after they arrive and takeover. But until they get there, continuous compressions do much more good than pausing every so often for breaths. If you really want to pause for breaths, do it no more than once every 2-3 minutes.

With drowning victims you need to get the airway clear, and probably several rescue breaths to start with, since they won't have the residual oxygen in their blood that a heart attack victim will, having used it up already. But even with them, the ideal interval between breaths is probably substantially longer than is usually practiced.

The good news is, in Canada anyways, that you cannot be held legally liable for any inadvertent damage you do to a person during CPR. Legally, they were dead already, so every little bit helps. Even if you screwed up the CPR completely and broke several of their bones, they're still better off than if you hadn't tried.

Interesting. I remember watching the old 70's show, Emergency, and seeing the two paramedics give CPR. I believe the standard at that time was 10 compressions and then one breath.

My brother was electrocuted while playing in a tree back in 1969. It happened in a remote area in Texas where it took an ambulance at least 30-40 minutes to arrive. My father said he attempted to resuscitate him but didn't really know what he was doing. My brother didn't make it beyond 3 days past his 9th birthday. My poor father who is now in his 80's still wonders if he could have saved my brother had he known how to correctly resuscitate him.

[alienlovechild 75]

My brother was electrocuted while playing in a tree back in 1969. It happened in a remote area in Texas where it took an ambulance at least 30-40 minutes to arrive. My father said he attempted to resuscitate him but didn't really know what he was doing. My brother didn't make it beyond 3 days past his 9th birthday. My poor father who is now in his 80's still wonders if he could have saved my brother had he known how to correctly resuscitate him.

Your dad shouldn't feel guilty as either method still has a low success rate. Only in the movies or TV does if seem to work with greater frequency. You give it your best shot as doing nothing is worse. The only thing you may worry about are states that don't have good samaritan laws, most do, but they vary.

"chest compression only cardiopulmonary resuscitation saved 12.5% of patients who were able to live to hospital discharge after being resuscitated while the conventional CPR saved 11%"

[HAL 9000 96]

Good info Dave.