Experts call to end first aid’s ‘kiss of life’
In a controversial move, the Australasian College of Emergency Medicine has recommended that mouth-to-mouth ventilation be abolished from national cardiopulmonary resuscitation (CPR) guidelines and replaced with chest compressions only, saying the move would save more people.The recommendation comes after two prestigious overseas studies found patients were more likely to survive without brain damage if CPR was administered without mouth-to-mouth.But the Australian Resuscitation Council (ARC), the peak body overseeing CPR guidelines, is resisting recommendations despite last year slashing the rate of breaths to compressions and eliminating pulse checks.Dr Stephen Bernard, of the Australasian College of Emergency Medicine, told The Sunday Telegraph latest research showed compression-only resuscitation was the best way to improve survival.(…)A study published in the Journal of the American Medical Association this month found patients of emergency workers who delivered compression-only resuscitation were three times as likely to survive.
– (2008-Mar-30) news.com.au
Minimally Interrupted Cardiac Resuscitation
Minimally interrupted cardiac resuscitation (MICR), a novel protocol for out-of-hospital cardiac arrest, includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, early administration of epinephrine, and delayed endotracheal intubation. To investigate whether MICR is associated with improved patient survival, Bobrow and colleagues (SEE ARTICLE) instructed emergency medical service personnel from 2 urban Arizona fire departments in MICR and assessed patient survival before and after instruction. In a second analysis, the authors reviewed data from 62 Arizona fire departments (12 trained in MICR) and compared survival among patients who received MICR vs those who did not. The authors report that survival to hospital discharge increased after implementation of MICR and was higher among patients who received MICR compared with those who did not. In an editorial, Peberdy and Ornato (SEE ARTICLE) discuss critical determinants of cardiac arrest survival and progress in resuscitation techniques and protocols.
– This Week in JAMA: JAMA. 2008;299(10):1105.
Minimally Interrupted Cardiac Resuscitation by Emergency Medical Services for Out-of-Hospital…
Bobrow et al.
JAMA.2008; 299: 1158-1165.
