Cardiopulmonary resuscitation for out of hospital cardiac arrest

doi:10.1136/bmj.39541.489699.80

BMJ 2008;336:782-783 (12 April), doi:10.1136/bmj.39541.489699.80 (published 7 April 2008)

Editorials

Cardiopulmonary resuscitation for out of hospital cardiac arrest

American Heart Association advocates chest compression withoutventilation

The first 150 words of the full text of this article appear below.

Is ventilation of the lungs necessary when starting cardiopulmonaryresuscitation (CPR) for out of hospital cardiac arrest? Increasingevidence shows that it has no effect on outcome and may evenmake matters worse. The American Heart Association has respondedto this controversy by publishing a statement "Hands-only (compression-only)CPR: a call to action for bystander response to adults who experienceout-of-hospital sudden cardiac arrest."¹ The main message ofthis statement is that by encouraging bystanders to provideat least chest compressions, the odds of survival from out ofhospital cardiac arrest will be improved.

Several animal studies show no survival benefit with the additionof ventilation during cardiopulmonary resuscitation.¹ A limitationof these studies, however, is that the airways of the animalsare generally patent, which may enable chest compressions aloneto generate some ventilation, particularly if gasping also occursduring chest compressions. Unconscious supine humans usuallyhave an obstructed . . . [Full text of this article]

Jasmeet Soar, consultant in anaesthesia and intensive care medicine¹, Jerry P Nolan, consultant in anaesthesia and intensive care medicine²

¹ Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, ² Royal United Hospital, Bath BA1 3NG

Jasmeet.soar@nbt.nhs.uk

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