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(Circulation. 2008;117:2162-2167.)
© 2008 American Heart Association, Inc.

AHA Science Advisory

Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest

A Science Advisory for the Public From the American Heart Association Emergency Cardiovascular Care Committee

Michael R. Sayre, MD; Robert A. Berg, MD, FAHA; Diana M. Cave, RN, MSN; Richard L. Page, MD, FAHA; Jerald Potts, PhD, FAHA; Roger D. White, MD

Key Words: AHA Scientific Statement • cardiopulmonary resuscitation • death, sudden • heart arrest • resuscitation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Bystanders who witness the sudden collapse of an adult should activate the emergency medical services (EMS) system and provide high-quality chest compressions by pushing hard and fast in the middle of the victim’s chest, with minimal interruptions. This recommendation is based on evaluation of recent scientific studies and consensus of the American Heart Association Emergency Cardiovascular Care (ECC) Committee. This science advisory is published to amend and clarify the "2005 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC)" for bystanders who witness an adult out-of-hospital sudden cardiac arrest.

Ten years ago, the AHA commissioned a working group of resuscitation scientists to reappraise the Association’s inclusion of ventilations in the recommended sequence for bystander cardiopulmonary resuscitation (CPR). The working group evaluated peer-reviewed reports of laboratory and human research and summarized their findings in a 1997 statement.¹ The key conclusion of that statement was that "Current guidelines for performing mouth-to-mouth ventilation during CPR should not be changed at this time."¹

In the animal studies cited in the 1997 statement, when ventricular fibrillation arrest was of short (under 6 minutes) duration, the addition of rescue ventilations to chest compressions did not improve outcome compared with chest compressions alone (LOE 6*).^2–8 Analysis of human data from a national out-of-hospital CPR registry documented no survival advantage to ventilations plus compressions compared with the provision of chest compressions alone during bystander resuscitation (LOE 4*).^9,10 Although these studies were not deemed sufficient to justify the elimination of ventilations from the bystander . . . [Full Text of this Article]

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