Duration of Ventilations During Cardiopulmonary Resuscitation by Lay-Rescuers and First Responders: Relationship Between Delivering Chest Compressions and Outcomes
Do interruptions in chest compressions for ventilation affect outcomes in patients undergoing cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA)?
Data on CPR in 199 patients (mean age 66 years) with OHCA were collected in a prospective database in the Netherlands, and correlated with neurologically intact survival to hospital discharge. Chest compression data were recorded by automatic external defibrillators.
The chest compression rate was slower than the recommended minimum rate of 100 bpm in 19% of patients and faster than the recommended maximum rate of 120 bpm in 23% of patients. The median chest compression fraction was 65%. The median interruption time for two ventilations was 7 seconds, with no significant difference between dispatched first-responders and lay bystanders. Survival to hospital discharge was 25%. The duration of ventilation-related pauses during chest compressions was not an independent predictor of survival.
The authors concluded that interruptions in chest compression for ventilation have a neutral effect on survival in patients undergoing CPR for OHCA.
The excellent performance of lay rescuers in this study reflects the quality of CPR training of the public in the Netherlands. Although ventilation-related pauses in chest compression did not correlate with survival in this study, it is noteworthy that the pauses were relatively brief, with only 17% of rescuers taking >10 seconds to deliver two ventilations. It is likely that ventilation-related pauses for lay bystanders in the United States are significantly longer. This has provided one of the arguments in favor of compression-only CPR by bystanders.
Keywords: Out-of-Hospital Cardiac Arrest, Ventilation, Cardiopulmonary Resuscitation, Netherlands
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