Cardiopulmonary resuscitation without ventilation

Current resuscitation methods, although occasionally effective, rarely perf orm as well as initially anticipated. Some of the disappointment can be att ributed to the difficulty of the task for many, including both professional and lay first responders. Significant attention has been paid recently to the need to simplify both the technique and the teaching of resuscitation. In considering simplification of the current resuscitation scheme, a logica l start is an honest reappraisal of the importance and priorities of each o f the once sacrosanct ABCs, specifically, establishment of an Airway, artif icial Breathing (mouth-to-mouth breathing), and chest compressions for temp orary Circulation, Experimental data continue to accumulate indicating that most important wit hin this triad is circulation. Adequate oxygen exists within the blood duri ng at least the first 10 mins of cardiac arrest, If circulation is provided to distribute such oxygen, no survival disadvantage results with chest com pression-only basic life support (BLS) efforts, Even a totally occluded air way during the first 6 mins of cardiac arrest does not compromise survival if reasonable circulation is provided with chest compressions. Clinical studies support the same conclusion that what most influences surv ival in any BLS effort is circulation, not ventilation, Belgium investigato rs have shown equal survival rates among those treated with chest compressi ons plus ventilation and those who received chest compressions alone. Telep hone dispatcher-guided BLS cardiopulmonary resuscitation (CPR) has likewise shown no survival disadvantage to chest compression-only CPR when compared with telephone-guided standard BLS CPR, Based on this reasoning, a new simplified BLS method has been proposed. "St aged" CPR consists of a strategy to Initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-m outh breathing. "Bronze" CPR, in which chest compression-only BLS is taught , was compared with the standard European Resuscitation Council BLS course for laypersons, Manikin "exit testing" at course completion has revealed si gnificant advantages of the simplified approach compared with standard CPR courses for the lay public.