CHAPTER 29 CHEST COMPRESSION ONLY CPR

Cardiopulmonary Resuscitation by Chest Compression Alone or With Mouth- to-Mouth Ventilation

Hallstrom A, Cobb L, Johnson E, et al. N Engl J Med. 2000;342(21):1546–1553

BACKGROUND

Prior to this study, it was a dogma that CPR provided by all persons included both chest compressions and interruptions for rescue breaths. Bystander-initiated CPR showed a mortality improvement of around 50% but was limited in cases where bystanders did not know how to do CPR. A prior study had demonstrated the value of dispatcher-instructed CPR but it took an average of 2.4 minutes to deliver the instructions. The most common reason CPR was not initiated was that Emergency Medical Services (EMS) had already arrived by completion of the instructions.

OBJECTIVES

To determine if changing the dispatcher instructions to have bystanders perform chest compressions without interruptions for ventilation would yield at least a 3.5% absolute increase in survival to hospital discharge.

METHODS

Prospective randomized controlled trial conducted in a single metropolitan US city EMS system.

Participants

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