Cough CPR

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Cough CPR is a resuscitation technique described in an email that began circulating around 1999, in which by coughing and deep breathing every 2 seconds a person suffering a cardiac arrhythmia immediately before cardiac arrest can supposedly keep conscious until help arrives (or until the person can get to the nearest hospital).

Although the technique is in fact taught to doctors, nurses and paramedics, this widely-circulated email confuses the difference between a "heart attack" and a "cardiac arrest". Cough CPR is intended only for imminent cardiac arrest. The American Heart Association does not endorse cough CPR during a heart attack.^[1].

This confusion appears to revolve primarily over the public's failure to discriminate between a heart attack and cardiac arrest. A heart attack occurs when an occlusion (e.g. blood clot) of an artery in the heart slowly causes tissue to die. This can result in chest pain and discomfort, and requires immediate medical attention to resolve the occlusion by emergency surgery or cardiac clot-busting drugs.

"Cardiac arrest" occurs when the heart stops beating, usually due to a heart attack, other prior medical condition or disturbance of the heart's electrical system. "Cough CPR" is intended not for a heart attack, but rather, imminent cardiac arrest, since coughing can increase blood pressure to the brain, preventing the person from fully arresting. Most people cannot identify when they are about to go into cardiac arrest unless they are monitored by an electrocardiogram at a hospital. The American Heart Association only recommends Cough CPR when a patient is monitored by an electrocardiogram with imminent signs of cardiac arrest.

Many experts are deeply concerned that people experiencing a heart attack may attempt to perform Cough CPR before attempting to call for emergency medical assistance first. The action of coughing itself may worsen myocardial ischemia and infarction (i.e. worsen a heart attack) due to the breath holding individuals experience while trying to cough, preventing the inhalation of oxygen.

[edit] Chain Emails

Cough CPR has been the subject of a series of chain email campaigns. These emails are typically of the following format:

HOW TO SURVIVE A HEART ATTACK WHEN ALONE

Since many people are alone when they suffer a heart attack, this article seemed in order. Without help the person whose heart stops beating properly and who begins to feel Faint, has only about 10 seconds left before losing consciousness. However, these victims can help themselves by coughing repeatedly and very vigorously. A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough must be repeated about every two seconds without let up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.

The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a phone and, between breaths, call for help.

Tell as many other people as possible about this, it could save their lives!