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Thread: Chest Compressions Without Mouth-to-mouth Better For Out-of-hospital Cardiac Arrest

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    ckb2001's Avatar
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    Chest Compressions Without Mouth-to-mouth Better For Out-of-hospital Cardiac Arrest

    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.

    http://www.sciencedaily.com/releases...0315210134.htm

    "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."
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    Puka-head's Avatar
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    Quote Originally Posted by ckb2001 View Post
    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.

    http://www.sciencedaily.com/releases...0315210134.htm

    "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."
    ------------------
    Wow that's new, I had to take CPR/ First Aid classes every year for twenty years and thats the first time I heard that. Would have been nice to know the four times I've had to do it now, I wonder if it would have made a difference with the one that I wasn't able to bring back.
    I do know a lot of people don't do CPR correctly due to lack of training but this changes the rules. I'll have to talk to my EMT buddy and see what they are doing now, it's been a few years since my last class.
    AND THE MORAL OF THE STORY IS:
    CHEATERS NEVER WIN!!!

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    ckb2001's Avatar
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    Quote Originally Posted by Puka-head View Post
    Wow that's new, I had to take CPR/ First Aid classes every year for twenty years and thats the first time I heard that. Would have been nice to know the four times I've had to do it now, I wonder if it would have made a difference with the one that I wasn't able to bring back.
    I do know a lot of people don't do CPR correctly due to lack of training but this changes the rules. I'll have to talk to my EMT buddy and see what they are doing now, it's been a few years since my last class.
    Well, take a copy of the article with you. Note that it says:

    "References: Cardiac Arrest -- Guideline Changes Urgently Needed. The Lancet 2007: 369: 882-884, by Gordon A. Ewy, MD Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. The Lancet 2007: 369: 920-26, by Ken Nagao, MD, et al."

    So, you can reference the actual journal article if necessary. Also, note this is a very recent article and usually it takes months or years before these things are assimilated by everyone that could benefit from that knowledge. So, your friend might not be aware of it yet.

    If he's in EMT, maybe the best is to just get a copy of the actual journal article and show that to him.
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    Puka-head's Avatar
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    Quote Originally Posted by ckb2001 View Post
    Well, take a copy of the article with you. Note that it says:

    "References: Cardiac Arrest -- Guideline Changes Urgently Needed. The Lancet 2007: 369: 882-884, by Gordon A. Ewy, MD Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. The Lancet 2007: 369: 920-26, by Ken Nagao, MD, et al."

    So, you can reference the actual journal article if necessary. Also, note this is a very recent article and usually it takes months or years before these things are assimilated by everyone that could benefit from that knowledge. So, your friend might not be aware of it yet.

    If he's in EMT, maybe the best is to just get a copy of the actual journal article and show that to him.
    I already emailed it to him, and my mom who teaches nursing in Hawaii.
    Wasn't doubting on you brah, it just really is news, thanks for sharing.
    The article does mention several times that this study was about when bystanders perform CPR, not trained professionals like EMT's. I think the main thrust was that strangers and bystanders will be more hesitant to do Mouth to mouth and it takes energy and time away from doing proper continuos compressions, which are more important.
    I think if you have two people mouth to mouth is still going to be the be the better way to go but I can see where chest compressions alone could be more properly done without having to switch back and forth.
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    If the mouth-to-mouth is not done correctly, the chances of air getting into the stomach is greater and that leads to potential reflux/aspiration of stomach contents into the trachea/lungs due to the chest compressions.........
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    Quote Originally Posted by Clumpy View Post
    If the mouth-to-mouth is not done correctly, the chances of air getting into the stomach is greater and that leads to potential reflux/aspiration of stomach contents into the trachea/lungs due to the chest compressions.........
    Yeah, that's true. But, I think this study is actually saying it's the interruptions of the chest compressions that's the key, meaning even IF the mouth-to-mouth is done correctly (I guess one implicit assumption they're making is only one person is doing this - otherwise you could do both..), only doing chest compressions is better than doing both mouth-to-mouth and chest compressions.
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    My wife took a CPR class about 6 weeks ago and they had mentioned that compressions are the only way to go.

    Don't waste you're time on the mouth to mouth.

    They also said that a common mistake on the compressions is that they aren't done hard enough. They had said that you need to "hear cracking" when you are giving the compressions. The cracking isn't the bones most likely but rather cartillage. They had said if you are going to err, err on the side of too hard rather that too soft. Too soft will do nothing. Worst case senario for compressions that are too hard are broken ribs.

    I thought it was interesting.
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    Very interesting, I was especially attracted to the part about how everyday/non CPR trained people might be more willing to do chest compressions alone versus MtM. I for one would have been hesitant to do mouth to mouth-there is a reason EMTs are given those special masks afterall, but I'd be much more willing to do chest compression until the paras arrive.
    Prepare to cast off the lines and set sail for fail!
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