Compression-Only CPR is Best for Untrained Bystanders

Kristi L. Koenig, MD, FACEP


Journal Watch. 2010;30(23) 

In This Article

Abstract and Introduction


A meta-analysis demonstrates that dispatcher-assisted chest-compression–only cardiopulmonary resuscitation increases survival compared with traditional CPR in adults with witnessed out-of-hospital cardiac arrest.


Recent studies have shown that bystander compression-only cardiopulmonary resuscitation (CPR) provides equal or superior outcomes to traditional CPR for adult cardiac arrest victims (JW Emerg Med Sep 2010, p. 65, and N Engl J Med 2010; 363:423, JW Emerg Med Nov 2010 p. 81, and JAMA 2010; 304:1447). To further examine this association, researchers conducted a two-part meta-analysis of studies published between 1985 and August 2010 that compared survival outcomes for compression-only CPR and traditional CPR in adults with out-of-hospital cardiac arrest.

In the primary meta-analysis, pooled data from three randomized trials (3031 patients) demonstrated significantly increased survival (at hospital discharge or 30 days) with dispatcher-assisted compression-only CPR, compared with dispatcher-assisted traditional CPR (absolute increase, 2.4%; number needed to treat, 41). In the secondary meta-analysis, pooled data from seven observational cohort studies (13,883 patients) showed no differences between compression-only and traditional CPR in rates of survival (at hospital discharge, 1 week, 14 days, or 30 days) or return of spontaneous circulation. (CPR was not dispatcher assisted in the cohort studies.) The authors estimate that the absolute increase in survival with compression-only CPR translates to an additional 8000 lives saved per year in the U.S., Canada, and the European Union combined.


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