Compression-only cardiopulmonary resuscitation for bystanders and first responders.
OBJECTIVE
The current resuscitation guidelines consider ventilation and chest compression essential components of resuscitation and therefore only one methodology, standard cardiopulmonary resuscitation, is explicitly recommended for the treatment of both respiratory and cardiac arrests. Pathophysiological and experimental observations argue that this generalization results in suboptimal treatment for victims of cardiac arrest.


RESULTS
For more than a decade animal studies have demonstrated that assisted ventilation is not essential during the initial treatment of a fibrillatory arrest; but only in the last year have these results been confirmed in humans. These new observations come from a handful of systems utilizing cardiocerebral resuscitation in their prehospital resuscitation of adult victims of presumed cardiac arrest. They have all demonstrated a dramatic increase in survival. Recent data also indicate that survival is significantly increased when laypersons perform chest-compression-only cardiopulmonary resuscitation.


CONCLUSIONS
The current resuscitation guidelines regarding the prehospital treatment of victims of adult cardiac arrest should be modified to explicitly permit the use of continuous-chest-compression cardiopulmonary resuscitation.
Kellum
Michael J
MJ
Rock and Walworth County Sudden Cardiac Death Project, Mercy Walworth Hospital and Clinic, Lake Geneva, Wisconsin, USA. Marcia@idcnet.com
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003256:Community Participation; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000628:therapy; D006801:Humans