Physician’s First Watch published a summary of an online posting by The Lancet this morning regarding a meta-analysis of outcomes for chest-compression-only versus standard cardiopulmonary resuscitation. This analysis related solely to “out-of-hospital” cardiac arrests.
The author of Physician’s First Watch gives the following summary of the Lancet study:
Researchers combined data from three randomized trials of dispatcher-assisted CPR for adults with out-of-hospital cardiac arrest and found that survival was significantly higher with chest compressions alone than with compressions plus rescue breathing (14% vs. 12%). Analysis of data from seven observational studies, however, found no difference between the methods (these studies did not examine dispatcher-assisted CPR).
The authors conclude: “Emergency medical services dispatch should instruct bystanders to focus on chest-compression–only CPR in adults with out-of hospital cardiac arrest. However, whether chest-compression–only CPR should be recommended for unassisted lay bystander CPR is unclear.”
The readers of our blog, Eye Opener, may recall that we recently did two pieces on automated external defibrillators (AED’s) – one relating to 24,000 defective AED’s, which were the subject of an FDA MedWatch Safety Alert, and the other premised on a reader’s comment to the first posting. It would be most interesting if there was data regarding the effectiveness of these devices versus either chest-compression-only and CPR interventions.
I’m not sure what the intent of The Lancet piece is other than what is listed in its “interpretation” summary:
For adults with out-of-hospital cardiac arrest, instructions to bystanders from emergency medical services dispatch should focus on chest-compression-only CPR.
I just hope that, if I ever find myself in a position of having to attend to someone who has suffered an out-of-hospital cardiac arrest, there is an EMS or someone with ACLS certification standing in the crowd.