Some practical advice if you find yourself faced with trying to resuscitate someone having suffered cardiac arrest and you are not at a hospital: the chances of surviving a cardiac arrest is twice as high if bystanders perform chest-compression-only resuscitation instead of traditional cardiopulmonary resuscitation (CPR) with mouth-to-mouth breathing.
"The report confirms that what we have learned in animal experiments applies to humans as well," says Gordon A. Ewy, MD, director of the Sarver Heart Center at The University of Arizona in Tucson where chest-compression-only resuscitation was developed. "Bystander-initiated continuous chest compressions without mouth-to-mouth breathing are the preferable approach for witnessed unexpected collapse, which is usually due to cardiac arrest."
"The study reported in The Lancet analyzed the outcomes of 4,068 cases of witnessed collapse of adults in the Kanto area in Japan. The prospective, multi-center observational study, named SOS-KANTO, is the first large-scale account comparing the survival rates of out-of-hospital cardiac arrest patients who were treated either with or without mouth-to-mouth ventilations by bystanders at the scene.
"For cardiac arrest, the term 'rescue breathing' is actually a paradox," says Ewy. "We now know that not only is it not helpful, but it's often harmful."
Studies showed that because current CPR guidelines call for mouth-to-mouth ventilations, the majority of people would not perform CPR on a stranger, partly out of fear of contracting diseases. Research by UA Sarver Heart Center member Karl B. Kern, MD, and others found that even if bystanders are willing to perform mouth-to-mouth ventilation, it takes too much time away from chest compressions, which have to be continuous to improve the chance of survival."