CURBSIDE- August 2010

Two New Studies Lend More Support To Compression-Only CPR.

NBC Nightly News (07/28/10, story 9, 1:45, Williams) reported, "The rules of CPR may be about to change," as two newly published studies "question the way millions of us learn to administer" it. Indeed, "most experts all agree the most important thing to do is call 9-1-1 immediately. It's the next part that's in dispute."

Now, new research "confirms" that "for bystanders with no training, chest compressions on adults are enough to restore life," ABC World News (07/28/10, story 7, 2:30, Sawyer) reported. "And there is no benefit to performing mouth-to-mouth resuscitation." This is noteworthy, because it's estimated that "only one third of those who go into cardiac arrest get CPR from a bystander. The hope is that by making it easier to do, more people will be willing to do it." The American Heart Association agrees with that line of thought, the CBS Evening News (07/28/10, story 7, 0:20, Couric) reported. It "says the simpler method will save more lives because it's easier to do."

In fact, the "American Heart Association, which trained 13 million people in CPR last year, is developing new guidelines for resuscitation that will be released in October," the Washington Post (07/29/10, Brown) reports. The "current guidelines encourage bystanders to at least do chest compressions, also known as hands-only CPR." The "prevailing theory is that not interrupting chest compressions with rescue breaths might ultimately deliver more oxygen than standard CPR in the crucial seven or eight minutes before paramedics arrive." Notably, "both studies, published Thursday in the New England Journal of Medicine, found a trend in that direction."

During the first and larger study, a team comprised of researchers from the University of Seattle and London "considered 1,941 people in cardiac arrest who needed bystanders to perform CPR until an ambulance arrived," Bloomberg News (07/29/10, Fridson) reports. "The scientists reported finding no significant difference between the 981 patients who received chest compression alone and the 960 who received both that procedure and mouth-to-mouth breathing." In fact, the "first group survived to hospital discharge at a rate of 12.5 percent and the second had an 11 percent survival rate, the scientists wrote."

The "second study was done in Sweden...included nearly 1,300 people," and reached similar conclusions, the AP (07/29/10, Stobbe) reports. "The studies also spotlighted the importance of having forceful dispatchers coaching bystanders," explained one expert who was not involved. "When dispatchers told callers to start CPR, about 80 percent attempted it when given hands-only instructions, more than the 70 percent who tried the standard version." The increase is being attributed to "dispatchers who immediately told callers what to do, instead of first asking them if they'd had CPR training or if they'd be willing to try it until medical help arrives."

There are, however, "exceptions to the" hands-only rule, according to the author of an editorial accompanying the studies. Dr. Myron Weisfeldt, of Johns Hopkins University, told CNN (07/29/10, Hellerman), "It is very important to understand that the patients in this study were adults and that for most children who suffer cardiac arrest, such as drowning victims, we must do rescue breathing." And, "patients with chronic lung disease or acute asthma, should also receive mouth-to-mouth."

The Los Angeles Times (07/29/10, Maugh) reports that "communities that are already using the new approach are seeing dramatic increases in survival of people who experience heart attacks, said Dr. Paul E. Pepe, head of the emergency medicine department of the University of Texas Southwestern Medical School in Dallas."

The Wall Street Journal (07/29/10, Wang, subscription required), the Boston Globe (07/28/10, Cooney) "White Coat Notes" blog, HeartWire (07/28/10, Wood), and HealthDay (07/28/10, Gordon) also covered the studies.