Things have changed significantly over the years. When I first became a paramedic it was an extremely rare thing to save someone who was in cardiac arrest. Today we teach our paramedic students that out of hospital cardiac arrest is a survivable event. When you look at all the changes in resuscitative care one thing has time and again shown to make the greatest difference in a positive outcome... a focus on high quality, minimally interrupted chest compressions.

In other words, Hands Only CPR saves lives.

There are many reason why hands only CPR is becoming the standard for CPR. The two most important reasons are research showed laypersons are way more likely to perform CPR on a stranger if they didn't have to do rescue breathing and minimally interrupted compressions significantly improved outcomes by maintaining blood flow to the brain during resuscitation.

Our protocols include minimally interrupted compressions for most adult cardiac arrest patients, patients receive 600-1000 compressions by EMS without a single rescue breath unless they get a pulse back. Compressions will be interrupted just long enough to defibrillate or to move the patient for better access of safety.

Arrests due to trauma, drownings, overdoses etc still have poor survival rates and will continue too for a long time... prevention is the primary "treatment" for this causes. But in arrest caused by cardiac issues... survival rates will continue to increase as more and more laypersons learn hands only CPR, as more dispatch systems instruct their callers to perform hands only CPR and as minimally interrupted compressions into more EMS and ED resuscitation protocols nationally.

UPDATED to add: I ran a quick report of adult cardiac arrests for my agency over the past 365 days. I removed all the patients that we did not attempt resuscitation (obviously dead). Here it is:
  • CPR was performed prior to our arrival: 78% of patients (adequately 66%)
  • Return of Spontaneous Circulation [ROSC]: 45% of patients
  • ROSC sustained to Discharge: 35% of patients
  • ROSC in patients where NO CPR was performed prior to EMS: 0.1% (0% to discharge)

These numbers reflect what we see in or region, and if I filter out the overdose and traumatic causes ROSC numbers will increase significantly... The most important lesson I get when I look at these numbers is good layperson CPR prior to EMS arrival makes the biggest difference in outcome.

Edited by Alan_Romania (04/13/20 07:41 PM)
"Trust in God --and press-check. You cannot ignore danger and call it faith." -Duke