Compression-only CPR could lead to better outcomes, study says

October 05, 2010
by Heather Mayer, DOTmed News Reporter
Cardiac arrest patients who received compression-only cardiopulmonary resuscitation outside of the hospital were more likely to survive to hospital discharge than those who received conventional CPR - rescue breathing and chest compressions - or no CPR at all, according to a study published in the Oct. 6 issue of the Journal of the American Medical Association.

In order to increase a sudden cardiac arrest patient's chance of survival, the state of Arizona instituted a program designed to educate bystanders to use compression-only CPR. This method of resuscitation is easier to teach, learn, remember and perform than conventional CPR, the researchers said.

"We wanted to make an intervention to improve survival, and one of the strategies was to increase the number of bystanders trying to help," said lead researcher Dr. Ben Bobrow.

Bobrow is also an associate professor of emergency medicine at the University of Arizona and the medical director for the Bureau of Emergency Medical Services and Trauma for the Arizona Department of Health Services.

Compression-only CPR, said Bobrow, has been shown to be more effective than conventional CPR.

"Anything that interrupted compressions was detrimental," he told DOTmed News, referring to previous studies.

Bobrow's study included adult patients, at least 18 years or older, who experienced out-of-hospital cardiac arrest between Jan. 2005 and Dec. 2009 in Arizona. A total of 4,415 adults with out-of-hospital cardiac arrest met all inclusion criteria for analysis, including 2,900 patients who received no bystander CPR, 666 who received conventional CPR and 859 who received compression-only CPR.

The researchers reported that rates of survival to hospital discharge were 5.2 percent for the no bystander group, 7.8 percent for conventional CPR and 13.3 percent for compression-only CPR. They also reported that the annual rate for lay rescuers providing any type of bystander CPR increased significantly over time, from 28.2 percent in 2005 to 39.9 percent in 2009. Bobrow attributes this increase to awareness and education of compression-only CPR.

"We believed [compression-only CPR] would improve outcomes, save more lives," Bobrow said. "I wouldn't say we were surprised [by the findings]. We were very encouraged. It wasn't that ... compression-only CPR would get more people to do any CPR, it turned out that compression-only CPR was associated with improved survival."

The researchers want people to take away from the findings that anyone can administer compression-only CPR to adults, and it's better than doing nothing.

"Anyone who is able to put one hand over the other, lock their elbows and push hard and fast can do this," he said. "This study will help convince communities across the country that they can do this. It will save many, many lives."

Children who experience SCA symptoms still require conventional CPR, said Bobrow. Conventional CPR is more appropriate because the reasons a child may experience SCA are likely due to respiratory problems, such as choking or drowning, which require rescue breaths.