More people can survive cardiac arrest if more viewers try CPR with their hands, Health News


More lives could be saved after cardiac arrest if viewers applied cardiopulmonary resuscitation (CPR), even if it was just the single-hands version, a new study suggests.

With hands-only CPR appearing as an alternative to the traditional method – chest compressions combined with mouth-to-mouth breaths – the Swedish researchers decided to investigate the impact of the simpler method.

They found that when rates of any type of CPR increased, the chances of surviving a sudden cardiac arrest doubled.

"In this national study (we have seen), a nearly six-fold increase in patients receiving only CPR," said co-author Dr. Jacob Hollenberg, director of the Resuscitation Center at the Karolinska Institute. "Any type of CPR was associated with duplicate survival rates compared to cases that did not receive CPR prior to the arrival of EMS."

Currently, it is not known whether cardiorespiratory resuscitation, including mouth-to-mouth resuscitation, when performed by onlookers, is superior to the simpler method, hands-on alone, Hollenberg said in an e-mail. There is a large randomized controlled trial under way to answer this question, he added.

Hollenberg suspects that more people would be willing to learn CPR only with their hands than the traditional method.

For the study published in Circulation, Hollenberg and his colleagues analyzed all cardiac arrest seen by out-of-hospital observers reported in the Swedish Cardiorespiratory Invasive Resuscitation Register between 2000 and 2017. In total, researchers had data on 30,445 patients.

The proportion of patients receiving CPR from viewers increased from 40.8% in 2000-2005 to 68.2% in 2011-2017. The proportion that received standard CPR was 35.4% in the previous period and 38.1% in the subsequent period. But at the same time, the proportion of people who received CPR with their hands only rose from 5.4% to 30.1%.

During the nearly two decades covered by the study, survival rates improved for both groups of patients. The 30-day survival after standard CPR increased from 9.4% to 16.2%, and after hands-only CPR it rose from 8.0% to 14.3%.

Overall, compared to patients who did not receive any type of CPR from onlookers, those who received standard CPR before rescuers arrived with 2.6 times more chances to survive up to 30 days and those who received only hand CPR had twice more chances to survive 30 days.

The study shows that any type of CPR is better than no CPR, said Dr. Clifton Callaway, vice president of emergency medicine at the University of Pittsburgh Medical Center. "This is a tremendously robust data set," Callaway said. "They have been able to track this for many, many years."

The American Heart Association has popularized CPR with its hands, Callaway said. "The message they're trying to convey is that if you do not choose to do mouth-to-mouth resuscitation, you can still do chest compressions and help someone with heart failure," he said, noting that word of mouth still is necessary for other conditions such as drowning.

The reason the hands can only work is that when people experience cardiac arrest, they still have oxygen in their lungs, Callaway said. "Chest compressions will give you some time until someone hits your heart again," he said.

The other advantage of hand-held CPR is that 911 operators can talk to you even if you do not have any training, Callaway said. "Dispatchers must be able to direct anyone to do chest compressions and provide that potential to sustain life until professional help arrives," he added. "In my opinion, there is no reason not to have 60% to 80% of Americans who had cardiac arrest receiving assistance from passersby."


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