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If you choose to follow any links to the complete text of articles listed below, you will be leaving the Strategian Web site. If you wish to return to this page from the Web page you are sent to, please use the Back option of your browser. Gordon A. Ewy Editorial: Cardiopulmonary Resuscitation -- Strengthening the Links in the Chain of Survival. (... when cardiac arrest occurs outside of a medical facility and/or away from trained medical personnel, the two major factors in whether the victim survives or not are whether and how quickly CPR [cardiopulmonary resuscitation] is applied by a bystander and then how quickly defibrillation is accomplished. The application of CPR buys time for defibrillation which actually stops the process of dying. However, traditional CPR--which involves a combination of mouth-to-mouth breathing and chest compression--is not often done by bystanders even among those who are trained in its use. The vast majority [of people seem to have] an aversion to mouth-to-mouth breathing, or a fear of infection. While assisted ventilation [accomplished through mouth-to-mouth breathing] is essential for respiratory arrest [which occurs more often in children and young adults], it is not as important in cases of cardiac arrest due to ventricular fibrillation in adults. In those cases, the most reasonable response is prompt, rapid, forceful chest compression--which, a cited study has shown, non-medical personnel find easier to learn, remember, and are more confident and comfortable in performing. The author reviews a study by Hallstrom and associates which [along with an earlier study by the same researchers] he describes as the most elegant studies to date that have confirmed in humans the laboratory finding in animals that in cases of witnessed sudden cardiac arrest with a nonrespiratory cause, CPR by chest compression alone is as good as, and possibly better than, the now standard CPR by compression plus ventilation. The author summarizes by stating that it is clear that the weakest links in the chain of survival after out-of-hospital cardiac arrest due to ventricular fibrillation are the lack of bystander-initiated basic CPR and the delay in defibrillation. We can strengthen these two critical links by encouraging the prompt use of CPR with chest compression alone by bystanders and by encouraging the appropriate use of automatic external defibrillators--from the text of the article; see the bibliography) The New England Journal of Medicine Volume 342, Number 21 (May 25, 2000): 1599-1601. **The complete text of this article is currently available through the Web site of The New England Journal of Medicine** Alfred Hallstrom, Leonard Cobb, Elise Johnson, and Michael Copass Cardiopulmonary Resuscitation by Chest Compression Alone or with Mouth-To-Mouth Ventilation. (... a study reviewed and described in an editorial by Gordon A. Ewy. The researchers conducted a randomized study to compare CPR [cardiopulmonary resuscitation] by chest compression alone with CPR by chest compression plus mouth-to-mouth ventilation. After analyzing data for over 500 individuals who received CPR, the authors conclude that the outcome after CPR with chest compression alone is similar to that after chest compression with mouth-to-mouth ventilation, and chest compression alone may be the preferred approach for bystanders inexperienced in CPR--from the text of the abstract) The New England Journal of Medicine Volume 342, Number 21 (May 25, 2000): 1546-1553. **An abstract of this article is currently available through the Web site of The New England Journal of Medicine** How to find the above journals, magazines, and other publications? See Step 3: Locate of the Information Strategy for details. Questions about any or all of the above? Please let me know. |
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