March 20, 2007 — A study has shown that for bystander cardiopulmonary resuscitation (CPR), the use of chest compressions alone without mouth-to-mouth ventilation is the preferable method for reviving people who have had out-of-hospital cardiac arrest.
The study, published in the March 17 issue of The Lancet, found no evidence for any benefit from the addition of mouth-to-mouth ventilation to chest compressions and that certain groups of patients had better outcomes with chest compressions alone.
An accompanying editorial states, "This critically important finding ... should lead to changes in guidelines. Advocating, encouraging, and teaching chest-compression only for witnessed unexpected sudden collapse will dramatically increase bystander initiated resuscitation efforts and thereby give these patients a better chance of survival when emergency personnel arrive."
The study authors, led by Ken Nagao, MD, from the Surugadai Nihon University Hospital in Tokyo, Japan, note that although bystander CPR improves the likelihood of survival for people with cardiac arrest, it is attempted in less than one third of patients who collapse. They say that one of the major barriers to bystanders performing CPR is their reluctance to undertake mouth-to-mouth ventilation, partly because of fear of transmission of infectious diseases, and the complexity of the CPR technique as presently taught.
They point out that cardiac-only resuscitation is recommended if a rescuer is unwilling or unable to do mouth-to-mouth ventilation, but that this technique is not generally taught to the public, and few clinical studies have evaluated this approach.
http://www.medscape.com/viewarticle/553839?rss
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