That might be slightly overstating the case. What they actually say is:
It is effective for a limited period only (probably less than 5 min) and is not recommended as the
standard management of out-of-hospital cardiac arrest.
Just to throw in my 2 pence worth to the discussion.....
It's nigh on impossible to get good quality research regarding the goings on around cardiac arrest - its not something you can double blind placebo control! Resuscitation guidelines are based on the limited research available (which is shoddy at best) and expert opinion. If you read the current guidelines it does elude to the fact that there is an increasing preponderance towards chest compressions for 1 simple fact - cessation of chest compressions leads to a loss of coronary perfusion pressure (ie the output from your heart that keeps blood going to the heart muscle itself). YEs, after a certain amount of time there will be a lack of oxygen in the blood that does reach the heart, but for bystander, or even first aider CPR, maintaining this coronary perfusion pressure is easier with compression only CPR (in the earlier quoted guideline they state they do not want to confuse people by changing guidance completely going off in a different direction), and personally I think this is the way things are going. It takes a good portion of the chest compressions (I’m remembering 10 to 15, but dont quote me) to regain an adequate coronary perfusion pressure.
It’s been said a couple of times that it is only effective for 5 minutes, but realistically if you do not have a paramedic in attendance within 5 minutes (who can give DC cardioversion hopefully restoring output, and if not intubate to allow asynchronous chest compressions and ventilation), you are a long way up S*** creek with no paddle. I work as part of the cardiac arrest team in the hospital, and to be perfectly honest even members of this team, who have been in their profession for many more years than I have, give suboptimal chest compressions. If in the group of professionals, whose job it is to do this on a day to day basis, struggle to perform adequate chest compression and thus maintain good coronary perfusion pressure, then jo public with bystander A doing CPR and attempting to blow expired gases into the lungs, losing about 8 - 10 seconds of CPR, thus losing the coronary perfusion pressure it took half the last cycle of chest compression to build up........ ah I think you get my point. Time will tell what the resus council go with when they next review the guidelines.
The kettle of fish may be a different one if you throw oxygen into the mix, because you are then putting more than 17% oxygen into the lungs, and it’s also slightly different if you have multiple trained people able to perform bystander CPR, as the down time between compressions is less if the second person is able to maintain an open airway and reduce the time taken to give breaths between compressions.
Dammit I knew I couldn’t hold the rant back forever!
Sorry to thread jack. THis is a useful thread, always good to compare kit lists and I will be updating my kit as result of some of the kit lists in here. Some interesting discussion too.
