Monday, 19 March 2007

Mouth-to-mouth resuscitation could do more harm than good

Skip mouth-to-mouth in emergency first aid; a new study has found that patients are twice as likely to survive a heart attack outside a hospital setting if bystanders perform chest-compression-only resuscitation instead of traditional CPR (cardiopulmonary resuscitation) with mouth-to-mouth breathing.

The study analysed the outcomes of 4,068 cases of resuscitation attempts performed by laypeople on adults who had collapsed from cardiac arrest. The observational study was based in the Kanto area in Japan, and is said to be is the first large-scale account comparing the survival rates of out-of-hospital cardiac arrest patients who were treated either with or without mouth-to-mouth ventilations by bystanders at the scene.

According to the study, which was led by Gordon A Ewy, director of the University of Arizona's Sarver Heart Center, mouth-to-mouth breathing takes too much time away from chest compressions, which have to be continuous to improve the chance of survival.

"We have found that the survival rate is higher even when the blood has less oxygen content, but is moved through the body by continuous chest compressions, than when the blood contains a lot of oxygen but is not circulated well because chest compressions are interrupted for mouth-to-mouth ventilations," Ewy said.

Poolside instructions for performing CPR
Ewy notes that eliminating the need for mouth-to-mouth ventilation not only is more effective, but also should dramatically increase the incidence of bystander-initiated resuscitation efforts, as studies have found that a majority of people currently are deterred from performing mouth-to-mouth on a stranger, partly out of fear of contracting diseases.

The study was published on March 17 in The Lancet. More information is available from the University of Arizona's press release.

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