AHA Call to Action: Compression-Only CPR

For adults with witnessed cardiac arrest, compression-only bystander CPR might improve survival.

The American Heart Association (AHA) has issued a call to action for bystanders who witness adult cardiac arrest to provide cardiopulmonary resuscitation using chest compressions only. This advisory amends the 2005 AHA guidelines for CPR and emergency cardiovascular care.

The AHA based the change on recent evidence, which suggests that the best strategy for resuscitating adults with non–asphyxia-related cardiac arrest is to start CPR quickly and to minimize interruptions of chest compressions. In addition, the AHA recognized that multiple reasons might cause bystanders to be unwilling or unable to provide rescue breathing (e.g., fear of contagion, lack of training). Current research demonstrates that survival outcomes are not worsened, and might be improved, by de-emphasizing bystander rescue breathing. The recommendation for compression-only CPR does not apply to arrest in children, unwitnessed cardiac arrest, or suspected asphyxia-related cardiac arrest (e.g., drug overdose, drowning).

Comment: We should advise our patients about this important change in recommendations. By simplifying CPR, the change might increase bystanders’ willingness to initiate CPR, especially on an unknown victim. The change, however, does not affect current recommendations for skilled providers who can provide chest compressions and ventilations efficiently with minimal interruption. The keys to the best outcome are getting CPR performed and minimizing the frequency and duration of any interruption in chest compressions.

— Aaron E. Bair, MD, MSc, FAAEM, FACEPPublished in Journal Watch Emergency Medicine April 11, 2008

Citation(s): Sayre MR et al. Hands-only (compression-only) cardiopulmonary resuscitation: A call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest. A science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation 2008 Mar 31; [e-pub ahead of print].

http://dx.doi.org/10.1161/CIRCULATIONAHA.107.189380