When you see a cardiac arrest, your brain fights you - "No, this isn't really happening" - and the circumstances fight you - "Dang! in CPR class the manikin didn't weigh very much and wasn't sitting in a deep chair. This blog deals with practical details and presents reports of "saves." Let me have your questions and comments - they will steer the course of this blog.
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Bystanders, forget about the breaths — pump that chest!
While rescue breathing might be important in certain situations, emergency medical service (EMS) dispatchers have a difficult time quickly establishing whether it's appropriate for individual victims. Compression-only cardiopulmonary resuscitation (CPR) obviates the need for this determination, but there have been no definitive long-term data supporting a shift to compression-only CPR.
Researchers combined data from two randomized trials comparing standard CPR with compression-only CPR and measured outcomes up to 5 years after the event. The aggregate group included 2500 patients. Overall survival was 11% at one year, 10.6% at 3 years, and 9.4% at 5 years. Compression-only CPR was associated with a lower risk for death (adjusted hazard ratio, 0.91).
Comment: While the rates of survival after CPR remain dismal, those who are fortunate to remain alive can look forward to a durable benefit. This study supports the 2010 Advanced Cardiac Life Support Guidelines and should encourage EMS dispatchers to instruct lay bystanders to initiate compression-only CPR in adult victims of cardiac arrest.