This week CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine (CJEM) that focuses on the most basic of skills: CPR. We know that CPR delivered by bystanders can increase the rate of survival from out-of-hospital cardiac arrest (OHCA), but all too often it is not done. In fact, it is performed <30% of the time in the Canadian context.

Featured in the latest CanadiEM infographic, this study by Cheskes et al [cite num=”1″] set out to determine whether Canadians are more willing to perform chest-compression-only CPR than traditional CPR, describe the public’s knowledge of OHCA, and identify factors that lead bystanders to perform CPR (or not!). The methodology involved a 32-item survey disseminated across Canada to 428 participants. Survey says: a significnatly greater proportion of respondents were up for chest-compression-only CPR compared to traditional CPR. This survey-based finding has been borne out in at least one recent registry study [cite num=”2″].

This study suggests that the general public has an aversion to traditional mouth-to-mouth CPR strong enough that it may prevent them from performing CPR, especially in certain populations. Previous randomized controlled trials have shown no difference in outcomes [cite num=”3,4,5″] although two meta-analyses of these three trials showed a benefit of chest-compression-only CPR over traditional CPR [cite num=”6,7″]. Observational studies have had conflicting results [cite num=”8,9″]. This study supports chest-compression-only CPR training for the general public and the endorsement of this practice by the Canadian Red Cross and American Heart Association. It can be read on the CJEM website [cite num=”1″] with key results reviewed in the infographic above.

The CanadiEM infographic section is edited by Alvin Chin (@AylC1989) and Calvin Yeh (@YehCalvin) and reviewed by our editorial team. Please help us spread the love for Compression-Only-CPR by sharing this infographic broadly on social media.

References Cheskes L, Morrison LJ, Beaton D, Parsons J, Dainty KN. Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)?-a nation-wide public survey. CJEM. 2015: 1-11. PMID: 26653895 Shimamoto T, Iwami T, Kitamura T, et al. Dispatcher instruction of chest compression-only CPR increases actual provision of bystander CPR. Resuscitation. 2015; 96: 9-15. PMID: 26206594 Hallstrom A, Cobb L, Johnson E, Copass M. Cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation. N Engl J Med. 2000; 342(21): 1546-53. PMID: 10824072 Svensson L, Bohm K, Castrèn M, et al. Compression-only CPR or standard CPR in out-of-hospital cardiac arrest. N Engl J Med. 2010; 363(5): 434-42. PMID: 20818864 Rea TD, Fahrenbruch C, Culley L, et al. CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010; 363(5): 423-33. PMID: 20818863 Hüpfl M, Selig HF, Nagele P. Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Lancet. 2010; 376(9752): 1552-7. PMID: 20951422 Cabrini L, Biondi-Zoccai G, Landoni G, et al. Bystander-initiated chest compression-only CPR is better than standard CPR in out-of-hospital cardiac arrest. HSR Proc Intensive Care Cardiovasc Anesth. 2010; 2(4): 279-85. PMID: 23439400 Bobrow BJ, Spaite DW, Berg RA, et al. Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010; 304(13): 1447-54. PMID: 20924010 Ogawa T, Akahane M, Koike S, Tanabe S, Mizoguchi T, Imamura T. Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study. BMJ. 2011; 342: c7106. PMID: 21273279

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