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Study: Chest compressions without mouth-to-mouth better for out-of-hospital cardiac arrest

A study published March 17, 2007 in The Lancet, one of the worlds foremost medical journals, finds that the chances of surviving a cardiac arrest outside a hospital setting are almost twice as high if bystanders perform chest-compression-only resuscitation instead of traditional cardiopulmonary resuscitation (CPR) with mouth-to-mouth breathing.

The study analyzed the outcomes of resuscitation attempts performed by laypeople at the scene after they witnessed a person collapse due to cardiac arrest.

"The report confirms that what we have learned in animal experiments applies to humans as well," says Gordon A. Ewy, MD, director of the Sarver Heart Center at The University of Arizona in Tucson where chest-compression-only resuscitation was developed. "Bystander-initiated continuous chest compressions without mouth-to-mouth breathing are the preferable approach for witnessed unexpected collapse, which is usually due to cardiac arrest."

In an invited editorial titled "Cardiac Arrest Guideline Changes Urgently Needed," published in the same issue of the journal, Ewy notes that eliminating the need for mouth-to-mouth ventilation not only is more effective, but also should dramatically increase the incidence of bystander-initiated resuscitation efforts.

Ewy and the Resuscitation Research Group at the UA Sarver Heart Center have advocated continuous chest compressions without assisted breathing as the appropriate method for cardiac arrest for years.

The study reported in The Lancet analyzed the outcomes of 4,068 cases of witnessed collapse of adults in the Kanto area in Japan. The prospective, multi-center observational study, named SOS-KANTO, is the first large-scale account comparing the survival rates of out-of-hospital cardiac arrest patients who were treated either with or without mouth-to-mouth ventilations by bystanders at the scene.

"For cardiac arrest, the term rescue breathing is actually a paradox,
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Contact: Daniel Stolte
stolte@email.arizona.edu
520-626-4083
University of Arizona Health Sciences Center
15-Mar-2007


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