Studies offer insight into potential CPR standard changes

We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths

By Art Hsieh
EMS1 Editorial Advisor

As the countdown continues toward the fall release of the American Heart Association Guidelines for emergency cardiac care, studies continue to provide insight into potential changes. Two such articles came across my Google Reader that I'd like to share.

The first is titled "CPR with Chest Compression Alone or with Rescue Breathing" and was conducted in both the United States (King and Thurston Counties, Wash.) and the United Kingdom (London).

The researchers wanted to find out if there were any differences in outcome in cardiac arrest based on whether bystanders were instructed to provide mouth to mouth rescue breathing, or if they were instructed to perform only chest compressions.

The results indicate that there were no differences in overall survival to discharge. There were "favorable trends" for performing compression-only CPR for patients who suffered sudden death from a cardiac cause, and there appeared to be an improvement in neurological outcome as well.

The second article looked at the prevalence of public access defibrillation (PAD) and its impact on survival. "Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System" is based on research being performed with the Resuscitation Outcomes Consortium (ROC), a multicenter, multiregional study group spread across the United States.

In this study, researchers looked at the impact of PAD in patients experiencing out of hospital cardiac arrests (OHCA). They found significant differences in survival to hospital discharge in those patients who had bystander CPR performed but did not receive pre-EMS defibrillation in public areas (9 percent), compared to those who did have an AED applied and a shock delivered (38 percent).

These studies continue to reinforce the notion that EMS must continue to participate in community-based activities that promote an immediate and appropriate bystander response to sudden cardiac arrest.

SCA continues to be our number one killer in the United States. We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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