Chest
Compression-Only CPR by Laypersons Saves More Cardiac Arrest Victims
Compression-only CPR
(COCPR) associated with about 60% improved survival compared with no
bystander CPR or conventional CPR
Oct. 5, 2010 –
The evidence is becoming overwhelming that CPR administered only by
chest compression – no mouth-to-mouth breathing help – is effective in
savings lives. And, maybe its best - a new study finds cardiac arrest victims were more likely
to survive when given compression-only CPR rather than conventional CPR
or no CPR by laypersons.
The Arizona
study looked at out-of-hospital CPR (cardiopulmonary resuscitation) for
cardiac arrest performed by bystanders and is reported in the October 6
issue of the Journal of the American Medical Association (JAMA).
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Alerts |
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This report
follows right behind a report in SeniorJournal.com that says
chest compressions before defibrillation in patients with sudden cardiac
arrest is equally successful as immediate treatment with an electrical
defibrillator. That study was by the University of Michigan Health
System. (See link in sidebar.)
Out-of-hospital
cardiac arrest is a major public health problem, affecting approximately
300,000 individuals in the United States annually. Although survival
rates vary considerably, outcomes can be improved with bystander CPR. In
2005, a statewide program was established in Arizona aimed at improving
survival.
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About Sudden Cardiac Arrest
Sudden cardiac arrest occurs when the heart
develops an arrhythmia (abnormal heart rhythm) that causes it to
stop beating. This is different than a
heart attack, where the heart usually continues to beat but
blood flow to the heart is blocked.
There are many possible causes of cardiac
arrest. They include coronary heart disease, heart attack,
electrocution, drowning, or choking. There may not be a known
cause to the cardiac arrest.
Without medical attention, the person will
die within a few minutes. People are less likely to die if they
have early cardiopulmonary resuscitation (CPR)
and defibrillation. Defibrillation is delivering an electric
shock to restore the heart rhythm to normal.
Ninety-five percent of people who have SCA
die from it—most within minutes. Rapid treatment of SCA with a
defibrillator can be lifesaving. A defibrillator is a device
that sends an electric shock to the heart to try to restore its
normal rhythm.
Automated external defibrillators (AEDs),
which often are found in public places like airports and office
buildings, can be used by bystanders to save the lives of people
who are having SCA.
Each year, between 250,000 and 450,000
Americans have sudden cardiac arrest (SCA). SCA occurs most
often in people in their mid-thirties to mid-forties. It appears
to affect men twice as often as women.
NIH: National Heart, Lung, and Blood Institute |
"These efforts
included changes in the approach to the care provided by both bystanders
and emergency medical services (EMS) personnel and were based on the
increasing evidence in favor of minimizing interruptions in chest
compressions during CPR," the authors write.
A multifaceted
effort was launched to encourage bystanders to use compression-only CPR
(COCPR) because this approach is easier to teach, learn, remember, and
perform than conventional CPR with rescue breathing, according to
background information in the article.
Bentley J.
Bobrow, M.D., of the Arizona Department of Health Services, Phoenix, and
colleagues evaluated whether widespread endorsement of COCPR for adult
sudden cardiac arrest would be associated with an increased likelihood
that lay rescuers would perform CPR and an increased likelihood of
survival to hospital discharge compared with no bystander CPR and
conventional CPR.
The study
included patients at least 18 years old with out-of-hospital cardiac
arrest between January 2005 and December 2009 in Arizona. A total of
4,415 adults with out-of-hospital cardiac arrest met all inclusion
criteria for analysis, including 2,900 who received no bystander CPR,
666 who received conventional CPR (15.1 percent), and 849 who received
COCPR (19.2 percent).
The researchers
found that rates of survival to hospital discharge were -
● 5.2 percent for the no bystander CPR group,
● 7.8 percent for conventional CPR, and
● 13.3 percent for COCPR.
The annual rate
for lay rescuers providing any type of bystander CPR increased
significantly over time, from 28.2 percent in 2005 to 39.9 percent in
2009.
"Among patients
who received bystander CPR, the proportion with COCPR increased
significantly over time, from 19.6 percent in 2005 to 75.9 percent in
2009.
“Overall
survival also increased significantly over time: from 3.7 percent in
2005 to 9.8 percent in 2009."
Further analysis
indicated that COCPR was associated with an approximately 60 percent
improved odds of survival compared with no bystander CPR or conventional
CPR.
The authors add
that there are multiple reasons COCPR may have advantages over
conventional CPR techniques, including the rapid deterioration of
forward blood flow that occurs during even brief disruptions of chest
compressions, the long ramp-up time to return to adequate blood flow
after resuming chest compressions, the complexity of conventional CPR,
the significant time required to perform the breaths, and the critical
importance of cerebral and coronary circulation during arrest.
American Heart Association Resuscitation Guideline
updates
www.heartcheckmark.biz/presenter.jhtml?identifier=3035517
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Chest Compression
Only CPR Can Succeed, But Not Without
Some Oxygen from Somewhere
‘For the first few minutes, it’s probably right
just to push on the chest. But at some point you probably need to add
oxygen, however you can’
 Nov. 30, 2009 – A study released today adds to the
efforts to find a cardiopulmonary resuscitation method that is effective
and easy to use. The favored CPR method had been a combination of chest
compressions and blowing of air into the victim’s lungs. Recently,
however, the American Heart Association has been reviewing chest
compressions alone as an acceptable alternative. This new report says,
however, that the victim is going to need some oxygen during this
process to survive.
Read more...
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New CPR Recommendation Takes Little Training – Just
Push Hard and Fast
Mouth-to-mouth no longer recommended for bystanders
trying to save lives
March 31, 2008 - Chest compressions alone, or
Hands-Only Cardiopulmonary Resuscitation (CPR), can save lives and can
be used to help an adult who suddenly collapses, according to a new
American Heart Association scientific statement posted on the Web site
today. Read more...
Very Low Survival after Out-of-Hospital Cardiac
Arrest Improved by New Resuscitation
MICR emphasizes minimal interruption of chest
compressions
March 11, 2008 – Those experiencing a cardiac
arrest outside of a hospital have a scant chance of survival, despite
massive efforts in cardiopulmonary resuscitation (CPR) training and
efforts to place more automated external defibrillators in public
places. A new study, however, finds hope in minimally interrupted
cardiac resuscitation (MICR), which emphasizes minimal interruption of
chest compressions during a rescue attempt.
Read more...
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