- Hands-only CPR boosts bystander resuscitation in Sweden
- Children need conventional CPR; black and Hispanic children more likely to get Hands-Only method
NOTE: ALL TIPS ARE EMBARGOED UNTIL 8 a.m. CT/ 9 a.m. ET, SATURDAY, NOV. 12, 2016.
Presentation: 14 Session: ReSS.AOS.11B
Hands-only CPR boosts bystander resuscitation in Sweden
Since guidelines have endorsed the use of compression-only or Hands-Only CPR by people not trained or unwilling to provide rescue breaths during resuscitation attempts, bystanders are trying to help at a far greater rate, according to a Swedish study presented at the American Heart Association’s Scientific Sessions 2016.
Using a national registry of 23,169 bystander-witnessed cases of out-of-hospital cardiac arrest, researchers compared the total rate of bystander CPR attempted and the proportions of standard CPR (rescue breaths and chest compressions) and Hands-Only CPR. They found:
Bystanders attempted to resuscitate a total of 38 percent of people in cardiac arrest before compressions-only-CPR was introduced into the guidelines, from 2000-2005.
During 2006-2010, after guidelines noted that dispatcher guidance of laypeople in compressions-only CPR might be preferable bystanders attempted resuscitation CPR rose to a total of 59 percent.
The total rate of CPR attempts rose to 70 percent during 2011-2014, after guidelines strongly recommended that dispatchers instruct untrained bystanders in compressions-only-CPR.
Most of the increase in bystander CPR during the last 15 years in Sweden was associated with increased use of compressions-only-CPR, from 5 percent in 2000-2005 to 15 percent in 2006-2010 to 28 percent in 2011-2014.
The 30-day survival of people with out-of-hospital cardiac arrest was not significantly different between those receiving compressions-only-CPR (13.6 percent) and standard CPR (12.9 percent), and either approach resulted in far higher survival than when no CPR was attempted (6.4 percent during 2011-2014).
Gabriel Riva, M.D., postgraduate student, Karolinska Institute, Stockholm, Sweden.
Note: Scientific presentation time is 11 a.m. CT, Sunday, Nov. 13 in Great Hall D.
Presentation: 20 Session: ReSS.13A
Children need conventional CPR; black and Hispanic children more likely to get Hands-Only method
While compressions-only or Hands-Only CPR is as good as conventional CPR for adults, children benefit more from the conventional approach that includes rescue breaths. But black and Hispanic children are more likely to receive the compressions-only method, according to research presented at the American Heart Association’s Scientific Sessions 2016.
Last year, Philadelphia researchers reported that bystander CPR on kids has increased and this year they report the comparison between conventional CPR attempts and Hands-Only attempts.
Using a large national registry in the United States, researchers examined the outcomes of out-of-hospital cardiac arrests in children 18 years and younger. Of 1,458 arrests treated with bystander CPR between 2013-2015, 49 percent of children received conventional CPR, 50 percent were given compressions-only CPR, and 1 percent had ventilation-only CPR. Among the findings:
Compressions-only CPR was used more often in black children (56 percent) and Hispanic children (64 percent) than in white children (49 percent).
Although black children were more likely to receive compressions-only CPR, their survival was better if they received conventional CPR.
Conventional CPR was associated with a 60 percent better chance of survival and a 50 percent better chance of being discharged from the hospital with good brain function.
Infants were more likely to receive conventional CPR, and that approach improved their survival more than compressions-only CPR.
Overall, survival was 17 percent for conventional CPR and 14 percent for compressions-only CPR.
The American Heart Association recommends conventional CPR (compressions and rescue breaths) for infants and children, but if rescuers are unwilling or unable to deliver breaths, they should perform compressions-only CPR.
Maryam Y. Naim, M.D., assistant professor Anesthesiology, Critical Care Medicine and Pediatrics, The Children’s Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine.
Note: Scientific presentation time is 3:45 p.m. CT, Sunday, Nov. 13 in Great Hall D.
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