title: Bystander mouth-to-mouth ventilation and regurgitation during cardiopulmonary resuscitation.
abstract: OBJECTIVE
  To determine whether there is an association between bystander mouth-to-mouth ventilation and regurgitation in prehospital cardiac arrest patients.
  
  
  METHODS
  Prospectively conducted observational study.
  
  
  METHODS
  Data were collected from patients treated by the emergency medical service (EMS) systems in three middle-sized or large Finnish urban communities, the Tampere District EMS and the physician-staffed Helicopter EMSs in the Helsinki and Turku areas in southern Finland.
  
  
  METHODS
  The study population consisted of 529 consecutive prehospital cardiac arrest patients with attempted resuscitation. Exclusion criteria were cardiac arrest due to trauma or drug overdose.
  
  
  METHODS
  Regurgitation in prehospital cardiac arrest patients documented by EMS personnel on the scene.
  
  
  RESULTS
  Regurgitation occurred in a fourth of patients. Bystander cardiopulmonary resuscitation (CPR) with mouth-to-mouth ventilation was associated with a significantly increased risk of regurgitation compared with no CPR (P < 0.013) and CPR without ventilations (P < 0.01).
  
  
  CONCLUSIONS
  The mode and role of bystander CPR in cardiac arrest needs to be further evaluated.
authors.affiliation: Department of Anaesthesia, Tampere University Hospital, Tampere, Finland. ilkka.virkkunen@uta.fi
authors.forename: I
authors.initials: I
authors.lastname: Virkkunen
authors.forename: S
authors.initials: S
authors.lastname: Kujala
authors.forename: S
authors.initials: S
authors.lastname: Ryynänen
authors.forename: A
authors.initials: A
authors.lastname: Vuori
authors.forename: V
authors.initials: V
authors.lastname: Pettilä
authors.forename: A
authors.initials: A
authors.lastname: Yli-Hankala
authors.forename: T
authors.initials: T
authors.lastname: Silfvast
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004632:Emergency Medical Services; D005260:Female; D005392:First Aid / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis