Talk:Cardiopulmonary resuscitation

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[edit] Compression-only (hands-only) CPR

I've started editing the article to take into account the AHA's stunning reversal on compression -only CPR (see changes in first paragraph). I thought they would have to do it with the Guidelines revision in 2010, but they surprised me. This is historic: 50 years of saying you need to do mouth-to-mouth, and now it turns out it doesn't matter. Some of the lay press articles (like the Canadian one that comes up at the top on a Google search for CPR) make it sound like this is merely a clarification of existing guidelines, but it's not. Formerly, it was do full CPR unless you're a squeamish little wimp, in which case you can just do chest compressions. Now the AHA is acknowledging that compressions-only is just as good in terms of survival--which of course means better, since bystanders will obviously do it more often and more quickly. I feel confident that further research will show CCPR is actually better for survival, but never mind for now.

I think the whole CPR article needs to be revised in light of this development. This is important because the article is used by the interested lay public. Let's make this a group effort. texasex (talk) 20:34, 12 April 2008 (UTC)

It is important to remember that this was only the guidance of the AHA, which is only one of the organisations which make up ILCOR who set the international guidance, and as an international encyclopaedia, the article should be reflective of this. Now, that isn't to say i'm not in favour of compression only CPR, and the ambulance service here uses protocol C, which comes from one of the academic studies which form the basis for high compression CPR, although it actually uses 200 compressions to 2 ventilations, with a high success rate. One of the reasons that compression only CPR is as least as effective as CPR with breaths is that the survival rate is only any good when there is early EMS intervention, who will certainly use airway intervention and ventilations - by this time the oxygen saturation won't have dropped. If the EMS is delayed, the survival rate with no ventilations will be lower if the airway is not secured, due to lack of oxygen to circulate. Because of the mixed guidance currently in circulation, the lack of firm evidence on compression-only efficacy in bystander pre-hospital and of course, because WP is not a how-to guide (that'll be Wikibooks) we should be careful in what is written here about it. OwainDavies (about)(talk) edited at 21:26, 12 April 2008 (UTC)

[edit] Skewed success rates?

Aren't the success rates of CPR skewed due to the population it's often used on? Meaning, CPR is rarely given on healthy teens, 20 or 30 year-olds. CPR is primarily used on the elderly or those with a pre-existing heart condition (i.e. heart disease). Therefore, their survival rate is already drastically lower than normal. -- MacAddct1984 13:53, 18 August 2007 (UTC)

That has not been my experience at all. I have observed more bystander CPR performed on young people, on those rare occasions they experience a sudden cardiac death. Paradoxically, younger people have less collateral circulation. They are not necessarily easier to resuscitate. Generally speaking, survival rates are abysmal due to failures in a community's chain of survival, and bystander CPR is only a small part of those failures. When you say "drastically lower than normal" you have to define "normal" and that's not easy to do, even for epidemiologists. MoodyGroove 14:32, 18 August 2007 (UTC)MoodyGroove
Have to agree here. Most elderly or infirm patients (high risk group) will die at home, with nobody able or willing to perform CPR on them. For younger patients, they are much more likely to be out in public, where there is a greater chance of CPR being performed. Have a look at some of the journals linked from the Prevalence and effectiveness section for more info on this. Owain.davies 19:03, 18 August 2007 (UTC)

[edit] Automated CPR devices

Then prove the notability, Owain.davies. The AutoPulse is a lot better known in the U.S. I've never heard of those other devices. MoodyGroove 19:05, 18 August 2007 (UTC)MoodyGroove

Are you now happy with the notability of the devices in this section? I think we now have a good balance between commercial links and references. Owain.davies 18:45, 23 August 2007 (UTC)

[edit] Comments about AutoPulse removed from article

These comments:

The autopulse device does have its problems as seen here, in the case of Riverside County Has Suspended Use of AutoPulse Jacket, where a 77yo man was subjected to the autopulse and later died from cracked ribs and internal injuries. The autopulse is purely mechanical, and so with no feedback will actually be detrimental to patient safety. Often called thumpers, these devices have been around for 40years, and will soon be phased out. Another autopulse trial against manual cpr here noted that the autopulse was harmful compared to manual CPR with the survival rate dropping from 10% with manual CPR to 6% with the autopulse.

were removed from the article because they give undue weight to anecdotal experiences with the device and do not conform to Wikipedia's neutral point of view policy. Please see the AutoPulse article for a more balanced review of the available evidence. MoodyGroove 13:00, 23 August 2007 (UTC)MoodyGroove


[edit] First Sentence

I will question the first sentence, CPR is used for people who "lost" pulse, not just Cardiac Arrest. October 20 2007 Kullwarrior —Preceding unsigned comment added by 68.149.170.5 (talk) 21:57, 20 October 2007 (UTC)

FYI, those mean the same thing. "Has lost their pulse" is colloquial language for "Is in cardiac arrest" – Mike.lifeguard | talk 23:03, 20 October 2007 (UTC)
American Heart Association protocols (based on the 2005 ILCOR protocols, I believe) also call for CPR in paediatric bradycardia. Given that CPR can be used even when a pulse is present but too weak to be felt, I'm happy with "cardiac arrest" given that this article is not intended to be overly technical. Andrewjuren(talk) 23:53, 20 October 2007 (UTC)
It is also called for during Ventricular Tachycardia (Where it goes pulseless), as there is no blood being pumped round the body anyway... —Preceding unsigned comment added by 172.206.95.11 (talk) 12:04, 15 March 2008 (UTC)


On reflection, this could be misleading, as you do use CPR for ineffective heat beats (such as in babies with a pulse < 60, for instance. I'll give the wording some thought. OwainDavies (about)(talk) edited at 12:18, 16 March 2008 (UTC)