An article in the NEJM and accompanying editorial suggests that
bystander cardiac compression is as good as full CPR, seems a good
study.
Your thoughts?
Matthew
> http://www.nejm.org/content/2000/0342/0021/1546.asp
>
> > Cardiopulmonary Resuscitation by Chest Compression Alone or with
> > Mouth-To-Mouth Ventilation
> >
> > Alfred Hallstrom, Leonard Cobb, Elise Johnson, Michael Copass
> >
> > Background. Despite extensive training of citizens of Seattle in
> > cardiopulmonary resuscitation (CPR), bystanders do not perform CPR in
> > almost half of witnessed cardiac arrests. Instructions in chest
> > compression plus mouth-to-mouth ventilation given by dispatchers over
> > the telephone can require 2.4 minutes. In experimental studies, chest
> > compression alone is associated with survival rates similar to those
with
> > chest compression plus mouth-to-mouth ventilation. We conducted a
> > randomized study to compare CPR by chest compression alone with
> > CPR by chest compression plus mouth-to-mouth ventilation.
> > Methods. The setting of the trial was an urban, fire-department-based,
> > emergency-medical-care system with central dispatching. In a
> > randomized manner, telephone dispatchers gave bystanders at the scene
> > of apparent cardiac arrest instructions in either chest compression
alone
> > or chest compression plus mouth-to-mouth ventilation. The primary end
> > point was survival to hospital discharge.
> > Results. Data were analyzed for 241 patients randomly assigned to
> > receive chest compression alone and 279 assigned to chest compression
> > plus mouth-to-mouth ventilation. Complete instructions were delivered
> > in 62 percent of episodes for the group receiving chest compression
> > plus mouth-to-mouth ventilation and 81 percent of episodes for the
> > group receiving chest compression alone (P=0.005). Instructions for
> > compression required 1.4 minutes less to complete than instructions for
> > compression plus mouth-to-mouth ventilation. Survival to hospital
> > discharge was better among patients assigned to chest compression
> > alone than among those assigned to chest compression plus mouth-to-
> > mouth ventilation (14.6 percent vs. 10.4 percent), but the difference
was
> > not statistically significant (P=0.18).
> > Conclusions. The outcome after CPR with chest compression alone is
> > similar to that after chest compression with mouth-to-mouth
ventilation,
> > and chest compression alone may be the preferred approach for
> > bystanders inexperienced in CPR. (N Engl J Med 2000;342:1546-53.)
> >
> >
> > Dr Matthew Cooke
> > Senior Lecturer in Emergency Care ( www.emerg-uk.com )
> > Emergency Medicine Research Group
> > Centre for Primary Health Care Studies, Univ of Warwick, CV4 7AL
> > Tel 07074 782377 Fax 0870 063 6506
> >
> >
>
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