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Heart Disease Health Center

CPR Without Mouth-to-Mouth Is Also Effective

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May 24, 2000 -- Although millions of Americans are trained in CPR, they may hesitate to use those skills on a stranger because they fear contracting diseases, particularly if they have to perform mouth-to-mouth resuscitation. A new study, though, shows that skipping this step and simply using the hands to press down on the chest of someone who has had a heart attack can work just as well.

For the study, published in TheNew England Journal of Medicine, researchers at the University of Washington in Seattle studied the survival rates of about 500 people suffering from apparent cardiac arrest. Half were given CPR plus mouth breathing, and half received only the technique called chest compression. The people helping the stricken patients were given instructions over the phone by emergency dispatchers and had not had CPR training.

To perform chest compressions, the heel of the right hand is placed in the center of the victim's chest, between the nipples, and the left hand is placed on top of it. The person then repeatedly pushes down about one to two inches until help arrives. In this study, there was virtually no difference in the survival rates of the two groups of people; in fact, those who received chest compressions alone did slightly better.

"If you find a stranger on the street, people are loath to do mouth-to-mouth, and there is every evidence that chest compression alone will be just as good," says Alfred Hallstrom, PhD, director of the Clinical Trials Coordinating Center in Seattle, which is affiliated with the University of Washington. Hallstrom, the lead researcher on the study, is also a professor of biostatistics at the university. "You don't need to feel guilty if you just do chest compressions."

This is particularly important when help is only four to six minutes away, he says, as researchers have not studied the value of chest compressions alone in situations where emergency assistance is slower to arrive.

Based on his findings, Hallstrom recommends giving chest compressions alone to anyone older than 50 -- who is more likely to be stricken by a heart attack rather than a stroke or airway blockage -- and giving chest compressions plus mouth-to-mouth breathing to anyone under 50.

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