CPR 'hands-only' guidelines may not be best for rural areas

May 1, 2013

Hands-only CPR (CPR without mouth-to-mouth resuscitation), may not be the best method for rural or remote areas or for anyone who has to wait more than a few minutes for an ambulance, a new study suggests.

New guidelines released by the in 2010 permit the use of simpler hand-only or compression-only CPR in some cases instead of conventional CPR. If ambulances come quickly, experts believe that instructing people to just "push hard, push fast" saves more lives.

But a literature review by Dr. Aaron Orkin found little evidence to support those guidelines outside of urban settings or in communities with no 911 services. His findings were published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

Of the 10 studies on saving lives with hands-only CPR he reviewed, only one included rural populations and people who had to wait longer than 15 minutes for an ambulance. Some of those studies showed that people who waited longer for ambulances to arrive had a better chance of surviving if mouth-to- was performed as well as .

"Urban studies can't always be applied outside big cities," said Dr. Orkin, a physician and graduate student affiliated with the University of Toronto, the Northern Ontario School of Medicine and Rescu, a St. Michael's Hospital research team dedicated to improving out-of-hospital resuscitation.

"Rural communities might need different CPR recommendations to urban settings," he said.

Dr. Orkin said he study suggests that "push hard, push fast" might be better refined to "push hard, push fast, if you're downtown."

One in five Canadians and nearly half of the world's population live in rural areas. Even in the most developed and densely populated cities, people can wait longer than 10 or 15 minutes for ambulance services

"If someone is unresponsive, doing any kind of CPR is clearly better than doing nothing," said Dr. Orkin. "But shouldn't CPR serve everybody, not just people who live a few minutes from an dispatch station or hospital?

Explore further: Extreme exertion does not impair the quality of CPR given by lifeguards

Related Stories

Recommended for you

Artificial heart design features porous plastic foam

October 2, 2015

Artificial hearts with multiple moving parts increase the chance of failure; scientists have worked up a device which is a single piece. No less interesting is the material they used; the team is taking a page out of soft ...

What powers the pumping heart?

September 25, 2015

Researchers at the Ted Rogers Centre for Heart Research have uncovered a treasure trove of proteins, which hold answers about how our heart pumps—a phenomenon known as contractility.

Sticky gel helps stem cells heal rat hearts

September 24, 2015

A sticky, protein-rich gel created by Johns Hopkins researchers appears to help stem cells stay on or in rat hearts and restore their metabolism after transplantation, improving cardiac function after simulated heart attacks, ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Jun 22, 2013
I learned more about this at compression-only-cpr.com

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.