CICM SAQ 2010.1 Q15

Reasons supporting the statement:

Physiological:

• In cardiac arrest heart dilates acutely. Decompression of the heart occurs with good compressions
• Ventilation can lead to decreased venous return
• Passive ventilation still occurs with compression only CPR
• Gasping can provide adequate ventilation and in presence of a partial airway obstruction may lead to increased venous return

Logistic reasons:

• Reluctance to perform mouth to mouth by rescuers therefore some people do not attempt CPR.
• Interruption to compressions therefore limiting their effectiveness
• Easier to teach compression only CPR.
• Out of hospital arrests it will minimise time to hospital. e) Useful particularly in the setting of a single rescuer

Studies:

• Mostly observational or animal. Some RCT
• No difference in outcome using compression only versus standard CPRs in most studies Evidence of value of good compressions

Against:

• Most studies are observational.
• Reported survival is no better with compression only therefore why change.
• Data for most studies are prior to the change in recommendation to 30:2 RATIO Ventilation is important for many arrests e.g. drowning/children/in hospital arrests ARC not recommend as standard practice

Present position:

• Not standard currently. Wait further studies. It can be used if rescuer is reluctant to use mouth to mouth