Chest compression-only CPR or good quality 30:2 CPR

Anantharaman V
Correspondence: Prof V Anantharaman, anantharaman@sgh.com.sg

ABSTRACT
There is debate as to whether chest compression-only cardiopulmonary resuscitation (CC-CPR) or standard 30:2 CPR should be taught to laypersons. Equivalence in outcomes between standard CPR and CC-CPR has been amply demonstrated in communities with short ambulance response times of about five minutes. Depriving oxygen from a collapsed patient beyond six minutes results in poorer outcomes. Communities with prolonged ambulance travel times have seen improved outcomes with CPR than CC-CPR. While healthcare workers demonstrate a reluctance to perform mouth-to-mouth ventilation, laypersons generally show a willingness to do so. Rescuer fatigue also argues against the use of CC-CPR for more than a few minutes. For communities with relatively long ambulance transport times, the best approach appears to be standard CPR, with emphasis on good quality compression. For dispatcher-assisted CPR, communication issues suggest that CC-CPR is advisable. Public CPR training should include teaching of mouth-to-mouth ventilation alternating with chest compressions.

Keywords: ambulance response times, chest compressions-only, dispatcher-assisted cardiopulmonary resuscitation, rescuer fatigue, standard cardiopulmonary resuscitation
Singapore Med J 2011; 52(8): 576-581