Key element of CPR missing from guidelines

by Anne Craig
Anthony Ho says CPR guidelines are missing a key component.

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Traditional CPR guidelines for out-of-hospital cardiac arrest by lay include rescue breaths. These are delivered using a combination of head tilt/chin lift and mouth-to-mouth breathing. Under the new guidelines, these are now omitted.

"Wholesale elimination of ventilation from CPR by laypersons for adults with out-of-hospital may be misguided," says Dr. Ho (Anesthesiology and Perioperative Medicine), who is also at Kingston General Hospital.

"It is important to remember that rescue breathing is a two-part intervention: head-tilt-chin-lift and delivery of rescue breaths. Head-tilt-chin-lift, the key to overcoming obstruction in the upper airway in unconscious patients, is not the reason for all the undesirable effects of rescue mouth-to-mouth breathing."

The new guidelines, issued by the International Liaison Committee on Resuscitation in 2010, recommend CPR using only chest compressions if performed by untrained bystanders. Mouth-to-mouth resuscitation was removed from the guidelines as it can delay or interrupt chest compressions, too much ventilation could be provided, and bystanders   may be reluctant to perform it.

With a survival rate of only 14 per cent for compression-only CPR, Dr. Ho says there is a lot of room for improvement. Dr. Ho's commentary was published in the most recent edition of the Canadian Medical Association Journal.

More information: Anthony M.-H. Ho, Song Wan, and David C. Chung. "Adding the head-tilt-chin-lift technique to adult compression-only CPR by untrained bystanders." CMAJ cmaj.131847; published ahead of print July 28, 2014, DOI: 10.1503/cmaj.131847

add to favorites email to friend print save as pdf

Related Stories

New studies confirm chest compressions alone

Dec 26, 2007

Two large-scale studies published in the Dec. 18 issue of the American Heart Association’s medical journal, Circulation, report that the chances of surviving cardiac arrest are no better – and may be worse – when b ...

Dispatcher-assisted CPR increases survival among children

Apr 30, 2014

Children who suffer cardiac arrest outside the hospital are more likely to survive and have good brain function if dispatchers instruct bystanders on CPR, according to a large Japanese study published in Journal of the Am ...

Recommended for you

Ebola scare boosts business for US company

14 hours ago

The Ebola scare has subsided in the United States, at least temporarily, but an Alabama manufacturer is still trying to catch up with a glut of orders for gear to protect against the disease.

Thai parliament votes to ban commercial surrogacy (Update)

22 hours ago

Thailand's parliament has voted to ban commercial surrogacy after outrage erupted over the unregulated industry following a series scandals including the case of an Australian couple accused of abandoning a baby with Down's ...

Doctor behind 'free radical' aging theory dies

Nov 25, 2014

Dr. Denham Harman, a renowned scientist who developed the most widely accepted theory on aging that's now used to study cancer, Alzheimer's disease and other illnesses, has died in Nebraska at age 98.

Mexican boy who had massive tumor recovering

Nov 25, 2014

An 11-year-old Mexican boy who had pieces of a massive tumor removed and who drew international attention after U.S. officials helped him get treatment in the southwestern U.S. state of New Mexico is still recovering after ...

User comments

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.