Efficacy of chest compression-only BLS CPR in the presence of an occluded airway

Reluctance of the lay public to perform bystander CPR is becoming an increa singly worrisome problem in the USA. Most bystanders who admit such relucta nce concede that fear of contagious disease from mouth-to-mouth contact is what keeps them from performing basic life support. Animal models of prehos pital cardiac arrest indicates that 24-h survival is essentially as good wi th chest compression-only CPR as with chest compressions and assisted venti lation. This simpler technique is an attractive alternative strategy for en couraging more bystander participation. Such experimental studies have been criticized as irrelevant however secondary to differences between human an d porcine airway mechanics. This study examined the effect of chest compres sion-only CPR under the worst possible circumstances where the airway was t otally occluded. After 6 min of either standard CPR including ventilation w ith a patent airway or chest compressions-only with a totally occluded airw ay, no difference in 24 h survival was found (10/10 vs. 9/10). As anticipat ed arterial blood gases were not as good, but hemodynamics produced were be tter with chest compression-only CPR (P < 0.05). Chest compression-only CPR , even with a totally occluded airway, is as good as standard CPR for succe ssful outcome following 6.5 min of cardiac arrest. Such a strategy for the first minutes of cardiac arrest, particularly before professional help arri ves, has several advantages including increased acceptability to the lay pu blic. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.