CPR Shifts Emphasis to Chest Compressions

Sudden cardiac death is the second leading cause of death in the United States, manifested in more than 325,000 cases each year. In many cases, there is little or no warning. The patient collapses with no blood pressure or pulse. The cause is generally a change in the electrical pattern of the heartbeat, either increasing it rapidly or irregularly. In these cases, CPR initiated immediately may keep the patient alive until emergency support arrives. A study completed recently revealed that one of the major reasons bystanders do not rush to help the victim is a fear of providing mouth-to-mouth breathing as part of standard CPR protocol. By-standers are afraid of doing something wrong or of actually touching the victim’s mouth. This Japanese study analyzed the results of more than 4,000 cases of cardiac arrest where the victim received standard CPR with mouth-to-mouth breathing or just cardiac compressions alone. What they discovered was those patients who received chest compressions only with no mouth-to-mouth breathing did just as well as those receiving standard CPR if rescue attempts began within 4 minutes of collapse. 

Mouth-to-mouth breathing is vital in cases of respiratory arrest (blocked airway, drowning, etc), but stopping chest compressions in cardiac situations to give breaths reduces the chance of maintaining the heart’s ability to respond to a defibrillator. Studies in Arizona and Wisconsin confirm these findings, with a tripling of survival rates when emergency personnel were trained in continuous chest compression (CCC) alone (American Journal of Medicine, April 2006). Some information remains the same. Every minute that passes without beginning emergency treatment reduces the victim’s chances of survival by 10%. Any treatment is better than no treatment; call 911 and begin chest compressions—as many as 100 per minute—while you wait for emergency personnel and the defibrillator. It may take a few minutes for the heart to beat on its own, so continue after the initial shock. After 2 minutes, shock the heart again and continue chest compressions. (For more information on providing CCC-CPR, go to heart.arizona.edu.)