Bystander CPR Is Now Much Easier and Just As Successful

For those of us who learned CPR (cardio-pulmonary resuscitation) many years ago, it may be hard to remember exactly what to do – was it Airway, Breathing, Compression, or Call, Blow, Pump?  Is it 2 breaths, 30 compressions, 2 breaths etc., or 2 breaths, 20 compressions, 2 breaths?  You can now stop trying to remember.  The latest New England Journal of Medicine carries 2 articles and an editorial agreeing that that there’s no difference in survival between bystander CPR given with or without rescue breathing; in other words, chest compressions alone are sufficient.       

The first study comes from the University of Washington, Seattle.  There were 1,900 patients with cardiac arrest who were called in to 911 by bystanders.  Dispatchers initiated CPR instruction to the bystanders, with patients randomly assigned to receive chest compression alone or chest compression plus rescue breathing.  The end-point was survival to discharge from hospital.  12.5% of patients lived to hospital discharge after chest compression, as did 11% who had chest compression and rescue breathing.

In the second study, which was from Sweden and had a similar design, 8.7% of patients had a 30-day survival with chest compression alone, and 7% with conventional CPR.  As the editorialist put it, the two studies lead to the straightforward conclusion that chest compression alone and with ventilation result in similar survival. 

A statement on these findings from the American Red Cross includes the following: “We recognize that upon witnessing the sudden collapse of an adult, calling 911 and providing compression-only CPR until an AED [automated external defibrillator] is available is an acceptable alternative for those who are unwilling, unable, or not trained to perform full CPR”.  In other words, there is still a place for assisted breathing, particularly in children.  However, there will probably be more volunteers among bystanders for the compression-only method, I believe.