Chest Compressions Alone Can Save The Life Of An Adult Who Suddenly Collapses

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Main Category: Cardiovascular / Cardiology
Also Included In: Public Health;  Nursing / Midwifery;  Primary Care / General Practice
Article Date: 31 Mar 2008 - 16:00 PDT

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If you are a lay bystander and come across an adult who suddenly collapses, remember that chest compressions (Hands-Only Cardiopulmonary Resuscitation) alone may save a life, says the American Heart Association. You do not have to give mouth-to-mouth if you do not know how - but chest compressions only could save a person's life.

You can read about this in Circulation, the journal of the American Heart Association.

Hands-Only Cardiopulmonary Resuscitation (Hands-Only CPR) is still useful for people who are not trained in conventional CPR, or those who do not feel confident enough to carry out conventional CPR. Conventional CPR consists of chest compressions and mouth-to-mouth breathing.

Michael Sayre, M.D., chair of the statement writing committee and associate professor in the Ohio State University Department of Emergency Medicine in Columbus, said "Bystanders who witness the sudden collapse of an adult should immediately call 9-1-1 and start what we call Hands-Only CPR. This involves providing high-quality chest compressions by pushing hard and fast in the middle of the victim's chest, without stopping until emergency medical services (EMS) responders arrive."

Approximately 310,000 US adults die annually from sudden cardiac arrest which happened outside an emergency department or a hospital setting. If a bystander does not assist with effective CPR the person's chances of surviving a sudden cardiac arrest drops by 7% to 10% per minute. Less than one third of people who suffer a cardiac arrest outside a hospital setting receive CPR from a bystander. According to the American Heart Association, bystander CPR can double or triple the patient's chances of surviving cardiac arrest.

If you don't know how to give mouth-to-mouth, do not refrain from giving Hands-Only CPR as you will be significantly improving the person's chances of survival, Sayre said. In other words, even if you are not trained, do it as you may contribute towards saving a life.

Sayre added "Many times people nearby don't help because they're afraid that they will hurt the victim and aren't confident in what they're doing. We want people to know that they can help many victims, just by calling 9-1-1 and doing chest compressions. Don't be afraid to try it. We are sure many lives will be saved if the public does Hands-Only CPR for adult victims of sudden cardiac arrest."

The new recommendation for Hands-Only CPR for adults who suddenly collapse is a revision of the 2005 American Heart Association Guidelines for CPR and ECC, which had recommended that lay rescuers use compression-only CPR only if they were unable/unwilling to provide breaths. This update puts Hands-Only CPR on par with conventional CPR when used for an adult who has suddenly collapsed. This change was supported by evidence published from three separate large studies in 2007, each describing the outcomes of hundreds of instances of bystanders performing CPR on cardiac arrest victims. None of those studies demonstrated a negative impact on survival when ventilations were omitted from the bystanders' actions. Hands-Only CPR is easier to remember and results in delivery of a greater number of chest compressions, with fewer interruptions, until more advanced care arrives on the scene.

The American Heart Association stresses that conventional CPR should continue to be given by medical and trained personnel. This new recommendation regarding hands-only CPR applies just to bystanders who are helping a cardiac arrest victim outside the hospital setting.

The American Heart Association adds that "Hands-Only CPR should not be used for infants or children, for adults whose cardiac arrest is from respiratory causes (like drug overdose or near-drowning), or for an unwitnessed cardiac arrest. In those cases, the victim would benefit most from the combination of chest compressions and breaths in conventional CPR."

-- More information on CPR training

"Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest - A Science Advisory for the Public From the American Heart Association Emergency Cardiovascular Care Committee"
Michael R. Sayre, MD; Robert A. Berg, MD, FAHA; Diana M. Cave, RN, MSN; Richard L. Page, MD, FAHA; Jerald Potts, PhD, FAHA; Roger D. White, MD
Circulation published online Mar 31, 2008 DOI: 10.1161/CIRCULATIONAHA.107.189380
Click here to view the advisory (PDF)

Written by - Christian Nordqvist
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