Thursday, October 7, 2010

Compression-Only CPR is Better

Using a simpler CPR resuscitation technique which only uses chest compressions saves more lives than traditional CPR, according to a new study.

The study, published by researchers from the Arizona Department of Health Services  in yesterday's edition of the prestigious Journal of the American Medical Association (JAMA), reviewed over 4,400 incidents where patients experienced cardiac arrest outside of a hospital setting, and where only bystanders were available to administer CPR. 849 patients received compression-only CPR, while 666 patients received traditional CPR. The other patients did not receive any CPR. Of the patients who received compression-only CPR, 13.3% survived, while 7.8% of those receiving traditional CPR survived. Only 5.2% of those who received no CPR at all survived. The differential between traditional CPR and compression-only CPR shows a 60% advantage for compression-only CPR.

The compression-only CPR process involves calling emergency services and immediately administering at least 100 compressions per minute to the chest - equivalent to the beat of the song Staying Alive, by the Bee-Gees. No breaths are given, and compressions are not interrupted. The traditional CPR process involves calling emergency services, opening the airway and clearing it, then administering in alternance 30 chest compressions and 2 breaths, where chest compressions are given at a rhythm of approximately 100 compressions per minute.

This conclusion of this study only reinforces findings that have been common to many other recent studies:
  • In September, a study published in the journal  BMC Medicine by researchers from the University of Michigan concluded that patients who experience sudden cardiac arrest outside of a hospital setting do as well when treated with compression-only CPR as they do when getting immediate defibrillation. 
  • In July, two studies testing compression-only CPR were published in the New England Journal of Medicine. One was conducted in Sweden, and covered more than 1,200 incidents. The other one, conducted in Seattle and in London, covered more than 1,900 incidents. Both studies found that chest compression-only CPR was as effective as traditional CPR when dealing with people experiencing a heart attack.
  • In 2009, data from the Arizona Center for Health Services from almost 5,000 incidents over 4 years showed that people treated with compression-only CPR were more likely to survive by a margin of 68% compared to regular CPR.

In 2008, on the heels of several years of studies showing the benefits of compression-only CPR, the American Heart Association published a statement recommending that bystanders not confident or trained in CPR call 911 and immediately start chest compression-only CPR. The statement followed the publication, in 2007, of three large studies, each one of which surveyed the outcomes of thousands of instances of CPR practiced by bystanders. Two large scale studies from Sweden and Japan were published in the journal Circulation, the Swedish study covering nearly 10,000 incidents, and the Japanese study covering 4,900 cases. Another Japanese study was published in the journal The Lancet, and covered more than 4,000 cases. All studies showed that the use of compression-only CPR had no worse, and sometimes much better results than that of traditional CPR.

The American Heart Association is expected to soon announce a significant change to its CPR guidelines.

Want to read more about it? Check Medscape, USA Today, iVillage, San Jose Mercury News, Science Daily, ABC News, CBC News, Wall Street Journal, and NIH Medline.

10/15/2010 Update: a new study published yesterday in the prestigious UK journal The Lancet confirms further the findings of the studies listed above, by analyzing the results of over 3,000 instances of CPR administered by bystanders guided by emergency dispatchers. Survival rates were 22% higher for compression-only CPR than for traditional CPR. More information in  NIH Medline, MedPage Today or Business Week HealthDay.

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