Updated June 2015
Is hands-only CPR best for rural areas too?
In 2010, the American Heart Association released guidelines urging bystanders to use hands-only CPR for witnessed cardiac arrests. But a literature review of 10 hands-only CPR studies calls that into question in rural areas, where people have to wait more than a few minutes for trained responders to arrive. Of the 10 studies, only one included rural populations in areas with response times of 15 minutes or longer, while the rest were in exclusively urban areas, researchers from St. Michael’s Hospital in Toronto report. And in seven of the studies, dispatchers provided telephone CPR instruction—which may not be available in rural areas and may make hands-only seem more effective than it would be without that instruction.
The authors conclude that there is too little research to know for sure if hands-only is superior to compressions with rescue breathing in areas with prolonged response times. “In settings with prolonged EMS response or travel times, the resuscitative efforts of bystanders may be even more important to OHCA survival,” the authors write. “The evidentiary basis for the AHA and ERC [European Resuscitation Council] guidelines does not attend to populations with prolonged EMS response times or a lack of formal EMS dispatch services.”
The study was published April 20 in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
Don’t foucus only on gyms for AEDs
Cardiac arrests are less likely to occur at gyms and fitness clubs than other exercise facilities, according to a study published online Aug. 7 in the Journal of the American College of Cardiology. Researchers from the University of Wisconsin School of Medicine and Public Health and colleagues analyzed cardiac arrests occurring at a public indoor location in Seattle and King County, Wash., between 1996 and 2008. Of 849 arrests, 52 occurred at health clubs and fitness centers; 84 occurred at other exercise sites, including tennis courts, community centers, bowling alleys, ice rinks and dance studios. The other 713 occurred in public indoor sites not associated with exercise.
That corresponds to one arrest every 42 years at a traditional exercise site; one every 11 years at a tennis facility; one every 13 years at an ice rink; and one every 27 years at a bowling alley. The rate of survival to discharge was also higher at traditional exercise facilities than other public indoor places, likely due to greater availability of AEDs. Survival rates were 56% at traditional exercise facilities, 45% at alternative exercise facilities and 34% in other buildings. When they suffered SCA, about 20% of victims were playing basketball; 12% were dancing or working out; 9% were using a treadmill; and 6% were playing tennis. About 5% each were bowling or swimming.
