Bystanders attending to an adult in cardiac arrest should perform the chest-compression-only technique of cardiopulmonary resuscitation (CPR), a new meta-analysis concludes.
The meta-analysis, published early online in The Lancet (doi:10.1016/S0140-6736(10)61454-7) included three studies that randomised patients to receive one of the two CPR techniques according to dispatcher instructions. This showed that chest-compression-only CPR improved the patients’ chance of survival compared with standard CPR (14% vs. 12%).
The authors comment that: “By avoidance of rescue ventilation during CPR, which is often fairly time-consuming for lay bystanders, a continuous uninterrupted coronary perfusion pressure is maintained, which increases the probability of a successful outcome”.
But they add that cohort studies suggest that standard CPR might be better than compressions-only CPR in patients whose cardiac arrest has a non-cardiac origin, such as drowning, trauma, or asphyxia. And there are not enough data on treating children with out-of-hospital cardiac arrest, which is often of non-cardiac origin.
But an accompanying editorial suggests that a few rescue breaths may be beneficial during CPR, as long as they don’t interfere with the compressions. They recommend that dispatchers instruct the bystander/rescuer to give 600 compressions over about six minutes followed by two rescue breaths and then compressions and ventilations in a ratio of 100:2 until the emergency medical personnel arrive.