Continuous Chest Compression Improves CPR

According to a recent study, when bystanders performed continuous chest compressions without mouth-to-mouth breathing, the chance of surviving a cardiac arrest outside a hospital was found to be twice as high compared to when bystanders performed standard cardiopulmonary resuscitation (CPR). The study was conducted by the Resusci­tation Re­search Group at the Uni­versity of Arizona (UA) Sarver Heart Center and the SHARE (Save Hearts in Ariz­ona Research and Edu­cation) Program at the Arizona De­partment of Health Services.

Only 5% of cardiac arrest victims survived if nobody performed CPR. In those receiving standard CPR (al­ternating between 30 compressions and 2 breaths), survival was marginally higher at 6%. In contrast, 11% survived if bystanders kept pumping on the victim’s chest and did not stop for mouth-to-mouth breaths un­til emergency medical services ar­rived. These trends were even more pronounced in those patients facing the highest survival chance to begin with due to the specific nature of their cardiac ar­rest, namely those whose collapse was witnessed and whose heart was in a rhythm that is most likely to respond to a shock from a defibrillator. In those, the survival rate was 17% without bystander CPR, 19% with standard CPR, and 32% with continuous chest compressions. While the percentage of by­standers administering CPR increased only slightly over the past 4 years, of those that did choose to help, 77% opted for chest compressions without mouth-to-mouth breathing instead of stand­ard CPR. Be­fore, that number was only 16%. The re­sults of the analysis included 4,850 out-of-hospital cardiac ar­rests in Ariz­ona that oc­cur­red from the years 2005 to 2009.

“This study is the first to show that bystanders can raise the odds of survival by giving continuous chest com­pressions rather than the type of CPR they are being taught in most certification classes,” states Gor­don A. Ewy, MD, director of the UA Sarver Heart Center. “If we can get more people to act, more patients who were on the brink of death will be walking out of the hospital neurologically intact.” Ac­cording to Bentley J. Bobrow, MD, medical director of the Bureau of Emer­gency Medi­cal Services & Trauma Sys­tem at the Arizona De­part­ment of Health Services, “All previously published reports only showed that bystander CPR was better than not doing any CPR until the paramedics ar­rive….Our state­wide efforts promoting com­pression-only CPR have re­sulted in significantly im­proved survival rates for pa­tients in out-of-hospital cardiac arrest.”