CPR guidelines should be changed
BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.334.7594.609-c (Published 22 March 2007) Cite this as: BMJ 2007;334:609
Bystanders who witness a cardiac arrest can safely forget the messy and difficult business of mouth to mouth ventilation and simply concentrate on continuous chest compressions until professional help arrives, says an editorial. There's good evidence that chest compressions alone work just as well as conventional cardiopulmonary resuscitation (CPR), and bystanders are more likely to help if they don't have to give someone the “kiss of life.”
The author was commenting on a recent study of 4068 cardiac arrests that occurred out of hospital in Japan (pp 920-6)⇑. Neurological outcomes were good for 6% (27/439) of those who had cardiac only CPR, 4% (30/712) of those who had conventional CPR, and 2% (63/2917) of those who had none. Any kind of resuscitation worked significantly better than none, and cardiac only CPR worked better than conventional CPR for important subgroups such as those with a shockable rhythm (19.4% with good neurological outcome v 11.2%, P=0.041). Among all patients who were resuscitated, cardiac only CPR was an independent predictor of good neurological outcome (adjusted odds ratio 2.2; 95% CI 1.2 to 4.2).
International guidelines should now be changed to reflect the new evidence, says the editorial. For average bystanders, mouth to mouth ventilation is ineffective, illogical, and simply interrupts the more important task of maintaining cerebral and coronary perfusion.