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(Circulation. 2007;116:2514-2516.)
© 2007 American Heart Association, Inc.

Editorial

Does Active Rescuer Ventilation Have a Place During Basic Cardiopulmonary Resuscitation?

Petter Andreas Steen, MD, PhD

From the University of Oslo, Faculty Division, Ulleval University Hospital, and Division of Prehospital Medicine, Ulleval University Hospital, Oslo, Norway.

Correspondence to Professor Petter A. Steen, Department of Anesthesiology, Ulleval University Hospital, N-0407 Oslo, Norway. E-mail p.a.steen@medisin.uio.no

Key Words: Editorials • cardiopulmonary resuscitation • heart arrest • ventilation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Rescuer ventilation has always been an integral part of both basic (BLS) and advanced (ACLS) cardiac life support.¹ Despite 5 decades of continuous attempts to improve training in cardiopulmonary resuscitation (CPR), maintenance of free airways and adequate ventilation continue to be difficult skills to acquire and maintain for both lay persons and professionals. Because of airway problems and excessive inflation pressures, much of the air enters the stomach instead of the lungs during bystander CPR,² and in a recent study, 39% of patients receiving mouth-to-mouth ventilation had signs of regurgitation at the time of intubation.³

Article p 2525

Bystander CPR increases overall survival in the great majority of clinical studies, but as suspected, the quality of the bystander effort is important. Poor-quality CPR did not increase survival compared with no CPR in 3 clinical studies.^4–6 In addition, although the frequency of bystander BLS is as high as 50% to 60% in areas with a long-standing tradition in lay-person CPR training and performance,^7,8 others report much lower and falling frequencies.⁹ This is at least partly due to rescuers’ reluctance to perform mouth-to-mouth ventilation because of fear of disease transmission or esthetic reasons.^10,11

Adding the difficulty of instructing ventilations over the telephone, Hallstrom et al⁷ conducted a randomized study of emergency dispatch telephone instruction in BLS with or without mouth-to-mouth ventilation with 14.6% survival for compressions only versus 10.4% for standard BLS (P=0.18).

In parallel, the CPR research group at the University of Arizona has over the last 15 years . . . [Full Text of this Article]

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				M. R. Sayre, R. A. Berg, D. M. Cave, R. L. Page, J. Potts, and R. D. White Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest: A Science Advisory for the Public From the American Heart Association Emergency Cardiovascular Care Committee Circulation, April 22, 2008; 117(16): 2162 - 2167. [Full Text] [PDF]