CPR: Compression-Only Wins the Long Race
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.
— J. Stephen Bohan, MD, MS, FACP, FACEP
Published in Journal Watch Emergency Medicine February 15, 2013
Dumas F et al. Chest compression alone cardiopulmonary resuscitation is associated with better long-term survival compared with standard cardiopulmonary resuscitation. Circulation 2013 Jan 29; 127:435. (http://dx.doi.org/10.1161/CIRCULATIONAHA.112.124115)