Chest compression only CPR should replace the current guidelines on CPR.
Critically evaluate this statement.
Answer and interpretation
Reasons supporting the statement:
- 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
- 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
- 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
- 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
- Not standard currently. Wait further studies. It can be used if rescuer is reluctant to use mouth to mouth