Chest compression only CPR

Chest compression only CPR should replace the current guidelines on CPR.

Reasons supporting the statement:

Physiological:

a) In cardiac arrest heart dilates acutely. Decompression of the heart occurs with good

compressions

b) Ventilation can lead to decreased venous return

c) Passive ventilation still occurs with compression only CPR

d) Gasping can provide adequate ventilation and in presence of a partial airway

obstruction may lead to increased venous return

Logistic reasons:

a) Reluctance to perform mouth to mouth by rescuers therefore some people do not

attempt CPR.

b) Interruption to compressions therefore limiting their effectiveness

c) Easier to teach compression only CPR.

d) Out of hospital arrests it will minimise time to hospital.

e) Useful particularly in the setting of a single rescuer

Studies:

Mostly observational or animal. Some RCT No difference in outcome using compression only versus standard CPRs in most studies Evidence of value of good compressions

Against:

Most studies are observational.

Reported survival is no better with compression only therefore why change.

Data for most studies are prior to the change in recommendation to 30:2 RATIO

Ventilation is important for many arrests EG drowning/children/in hospital arrests

ARC not recommend as standard practice

Present position:

Not standard currently. Wait further studies. It can be used if rescuer is reluctant to use mouth to mouth

Comments

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