Chest presses better than CPR

A patient going into cardiac arrest outside a hospital setting is more likely to survive if bystanders perform chest-compression-only resuscitation than traditional CPR, US researchers have found.

They recommend that resuscitation guidelines should be changed to reflect this finding.

Of the neurological outcomes of 4,068 adult patients who suffered cardiac arrest outside a hospital, 439 were given chest-compression-only resuscitation by a bystander, 712 were given CPR and 2,917 received no resuscitation. Any resuscitation attempt increased the patient’s chances of a good neurological outcome from 2.2 to 5 per cent.

Better outcomes were seen following chest-compression-only resuscitation than CPR in patients with apnoea and shockable rhythm. It was also more successful than CPR in those who were given resuscitation within four minutes of arrest.

Also, there was no benefit from the addition of mouth-to-mouth ventilation in any subgroup.

Lead researcher Dr Gordon Ewy, director of the Sarver Heart Center at the University of Arizona in Tucson, concluded: ‘Bystander-initiated continuous chest compressions without mouth-to-mouth breathing are the preferable approach for witnessed unexpected collapse, which is usually due to cardiac arrest.’

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