title: Chest compression-only cardiopulmonary resuscitation performed by lay rescuers for adult out-of-hospital cardiac arrest due to non-cardiac aetiologies.
abstract: OBJECTIVE
  Bystander CPR improves survival in patients with out-of-hospital cardiac arrest (OHCA). For adult sudden collapse, bystander chest compression-only CPR (COCPR) is recommended in some circumstances by the American Heart Association and European Resuscitation Council. However, adults who arrest from non-cardiac causes may also receive COCPR. Because rescue breathing may be more important for individuals suffering OHCA secondary to non-cardiac causes, COCPR is not recommended for these cases. We evaluated the relationship of lay rescuer COCPR and survival after OHCA from non-cardiac causes.
  
  
  METHODS
  Analysis of a statewide Utstein-style registry of adult OHCA, during a large scale campaign endorsing COCPR for OHCA from presumed cardiac cause. The relationship between lay rescuer CPR (both conventional CPR and COCPR) and survival to hospital discharge was evaluated.
  
  
  RESULTS
  Presumed non-cardiac aetiologies of OHCA accounted for 15% of all cases, and lay rescuer CPR was provided in 29% of these cases. Survival to hospital discharge occurred in 3.8% after conventional CPR, 2.7% after COCPR, and 4.0% after no CPR (p=0.85). The proportion of patients receiving COCPR was much lower in the cohort of OHCA from respiratory causes (8.3%) than for those with presumed cardiac OHCA (18.0%; p<0.001).
  
  
  CONCLUSIONS
  In the setting of a campaign endorsing lay rescuer COCPR for cardiac OHCA, bystanders were less likely to perform COCPR on OHCA victims who might benefit from rescue breathing.
authors.affiliation: Arizona Emergency Medicine Research Center, Department of Emergency Medicine, University of Arizona, Tucson, AZ 85724, USA. apanchal@aemrc.arizona.edu
authors.forename: Ashish R
authors.initials: AR
authors.lastname: Panchal
authors.forename: Bentley J
authors.initials: BJ
authors.lastname: Bobrow
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Spaite
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
authors.forename: Tyler F
authors.initials: TF
authors.lastname: Vadeboncoeur
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Sanders
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
authors.forename: Gordon A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D000368:Aged; D001130:Arizona; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies