Cardiopulmonary resuscitation without ventilation

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Current resuscitation methods, although occasionally effective, rarely perform as well as initially anticipated. Some of the disappointment can be attributed 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 logical start is an honest reappraisal of the importance and priorities of each of the once sacrosanct ABCs, specifically, establishment of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest compressions for temporary Circulation. Experimental data continue to accumulate indicating that most important within this triad is circulation. Adequate oxygen exists within the blood during at least the first 10 mins of cardiac arrest. If circulation is provided to distribute such oxygen, no survival disadvantage results with chest compression-only basic life support (BLS) efforts. Even a totally occluded airway 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 survival in any BLS effort is circulation, not ventilation. Belgium investigators have shown equal survival rates among those treated with chest compressions plus ventilation and those who received chest compressions alone. Telephone 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. 'Staged' CPR consists of a strategy to initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-mouth 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 significant advantages of the simplified approach compared with standard CPR courses for the lay public.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume28
Issue number11 SUPPL.
StatePublished - 2000

Fingerprint

Cardiopulmonary Resuscitation
Ventilation
Thorax
Mouth Breathing
Resuscitation
Heart Arrest
Telephone
Oxygen
Manikins
Belgium
Mouth
Teaching
Research Personnel

Keywords

  • Basic life support
  • Cardiopulmonary resuscitation
  • Chest compression-only cardiopulmonary resuscitation
  • No-ventilation cardiopulmonary resuscitation
  • Staged cardiopulmonary resuscitation
  • Sudden cardiac death
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Cardiopulmonary resuscitation without ventilation. / Kern, Karl B.

In: Critical Care Medicine, Vol. 28, No. 11 SUPPL., 2000.

Research output: Contribution to journalArticle

@article{230db2da79964ba999b691ccab10306e,
title = "Cardiopulmonary resuscitation without ventilation",
abstract = "Current resuscitation methods, although occasionally effective, rarely perform as well as initially anticipated. Some of the disappointment can be attributed 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 logical start is an honest reappraisal of the importance and priorities of each of the once sacrosanct ABCs, specifically, establishment of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest compressions for temporary Circulation. Experimental data continue to accumulate indicating that most important within this triad is circulation. Adequate oxygen exists within the blood during at least the first 10 mins of cardiac arrest. If circulation is provided to distribute such oxygen, no survival disadvantage results with chest compression-only basic life support (BLS) efforts. Even a totally occluded airway 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 survival in any BLS effort is circulation, not ventilation. Belgium investigators have shown equal survival rates among those treated with chest compressions plus ventilation and those who received chest compressions alone. Telephone 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. 'Staged' CPR consists of a strategy to initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-mouth 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 significant advantages of the simplified approach compared with standard CPR courses for the lay public.",
keywords = "Basic life support, Cardiopulmonary resuscitation, Chest compression-only cardiopulmonary resuscitation, No-ventilation cardiopulmonary resuscitation, Staged cardiopulmonary resuscitation, Sudden cardiac death, Ventricular fibrillation",
author = "Kern, {Karl B}",
year = "2000",
language = "English (US)",
volume = "28",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "11 SUPPL.",

}

TY - JOUR

T1 - Cardiopulmonary resuscitation without ventilation

AU - Kern, Karl B

PY - 2000

Y1 - 2000

N2 - Current resuscitation methods, although occasionally effective, rarely perform as well as initially anticipated. Some of the disappointment can be attributed 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 logical start is an honest reappraisal of the importance and priorities of each of the once sacrosanct ABCs, specifically, establishment of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest compressions for temporary Circulation. Experimental data continue to accumulate indicating that most important within this triad is circulation. Adequate oxygen exists within the blood during at least the first 10 mins of cardiac arrest. If circulation is provided to distribute such oxygen, no survival disadvantage results with chest compression-only basic life support (BLS) efforts. Even a totally occluded airway 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 survival in any BLS effort is circulation, not ventilation. Belgium investigators have shown equal survival rates among those treated with chest compressions plus ventilation and those who received chest compressions alone. Telephone 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. 'Staged' CPR consists of a strategy to initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-mouth 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 significant advantages of the simplified approach compared with standard CPR courses for the lay public.

AB - Current resuscitation methods, although occasionally effective, rarely perform as well as initially anticipated. Some of the disappointment can be attributed 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 logical start is an honest reappraisal of the importance and priorities of each of the once sacrosanct ABCs, specifically, establishment of an Airway, artificial Breathing (mouth-to-mouth breathing), and chest compressions for temporary Circulation. Experimental data continue to accumulate indicating that most important within this triad is circulation. Adequate oxygen exists within the blood during at least the first 10 mins of cardiac arrest. If circulation is provided to distribute such oxygen, no survival disadvantage results with chest compression-only basic life support (BLS) efforts. Even a totally occluded airway 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 survival in any BLS effort is circulation, not ventilation. Belgium investigators have shown equal survival rates among those treated with chest compressions plus ventilation and those who received chest compressions alone. Telephone 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. 'Staged' CPR consists of a strategy to initially teach laypersons a simplified approach to BLS, which requires only chest compressions and not mouth-to-mouth 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 significant advantages of the simplified approach compared with standard CPR courses for the lay public.

KW - Basic life support

KW - Cardiopulmonary resuscitation

KW - Chest compression-only cardiopulmonary resuscitation

KW - No-ventilation cardiopulmonary resuscitation

KW - Staged cardiopulmonary resuscitation

KW - Sudden cardiac death

KW - Ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=0033678741&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033678741&partnerID=8YFLogxK

M3 - Article

VL - 28

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 11 SUPPL.

ER -