Key element of CPR missing from guidelines

July 29, 2014 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.

Explore further: Eliminating mouth-to-mouth boosts CPR results, study shows

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

Related Stories

Eliminating mouth-to-mouth boosts CPR results, study shows

December 10, 2012
(HealthDayNews)—Bystander CPR saves more lives when just chest compression is performed without mouth-to-mouth resuscitation, a new study from Japan shows.

Study compares outcomes of device for chest compressions vs manual CPR

November 17, 2013
Sten Rubertsson, M.D., Ph.D., of Uppsala University, Sweden and colleagues assessed whether cardiopulmonary resuscitation (CPR) in which chest compressions are delivered with a mechanical device would result in superior 4-hour ...

Dispatcher-assisted CPR increases survival among children

April 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 American ...

9-1-1 dispatchers can save more lives by coaching bystanders in CPR

January 9, 2012
More people will survive sudden cardiac arrest when 9-1-1 dispatchers help bystanders assess victims and begin CPR immediately, according to a new American Heart Association scientific statement published in Circulation: ...

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 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.