In the Literature: Research You Need to Know


Clinical Question: Is chest-compression-only bystander cardiopulmonary resuscitation (CPR) as effective as conventional CPR with rescue breathing for out-of-hospital cardiac arrest?

Background: Out-of-hospital cardiac arrest is a major public health problem, affecting approximately 300,000 people in the U.S. annually. Overall survival is generally less than 10% among those in whom resuscitation is attempted. Bystander CPR significantly improves outcomes but generally is performed in less than 30% of cases.

Study design: Prospective, observational cohort study.

Setting: Communities throughout the state of Arizona.

Synopsis: State officials undertook a multifaceted public service campaign to educate, inform, and encourage the use of compression-only CPR.

Over a period of four years, 5,272 adult out-of-hospital cardiac arrests were documented in Arizona. A total of 4,415 of these incidents met all of the inclusion criteria for analysis; 2,900 received no CPR, 666 received conventional CPR, and 849 received compression-only CPR. Rates of survival to hospital discharge were 5.2% for the no-CPR group, 7.8% for conventional CPR, and 13.3% for compression-only CPR.

Additionally, the successful public service campaign increased the use of lay rescuer conventional CPR by 10% and compression-only CPR by 56%.

Bottom line: Layperson, compression-only CPR was associated with an overall 6.1% increased survival compared with conventional CPR and no bystander CPR.

Citation: Bobrow BJ, Spaite DW, Berg RA, et al. Chest-compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010;304(13):1447-1454.

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