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Focus on chest for CPR: study
A new study has recommended untrained bystanders who try to resuscitate cardiac arrest patients skip mouth-to-mouth and focus on the chest compressions.

The study, published in the Journal of the American Medical Association , found the simplified version of CPR improved the odds of survival by about 60 per cent.

The research found one reason "compression only" CPR works is that bystanders are far more likely to give it a go.

Many people are reluctant to try mouth-to-mouth resuscitation, either because it seems too complicated, they are worried about infection, or because they panic.

The chief medical adviser to the National Heart Foundation, Professor James Tatoulis, says there are also clinical reasons why it may be a better option.

"If you perform resuscitation with only chest compressions, and you do it immediately - because you're less reluctant to start - and you do it forcibly and rhythmically and don't interrupt then you establish more forward flow and better circulation for that period of time," he says.

"As well as that, obviously it's a simpler technique and it's easier to teach."
'Compelling evidence'

The study found the survival rate for patients who only received compressions was about 13%, compared with roughly 8% for traditional CPR.

The research was performed in Arizona, where the state health authorities made a decision several years ago to encourage bystanders to attempt compression-only CPR.

The overall survival rate for people who suffered cardiac arrest in public tripled since 2005 and now sits at just under 10%.

Tatoulis says it is compelling evidence and he believes Australia's medical authorities may well follow suit.

"I think, at the moment, the Americans are in the process of developing their new guidelines and I'm sure Australia will take notice," he says.

"We've already been conceptually heading down this path and I don't doubt that we will also form guidelines along this particular path as well."
Not all cases

But not everyone is convinced compression-only CPR is a better option for Australia.

The deputy chairman of the Australian Resuscitation Council's Queensland branch, Darryl Clare, believes it is better to stay with traditional CPR.

"At the moment, certainly, research is saying for Australia it's probably best to stick with traditional CPR," he says.

"Still saying, though, that where a person is unwilling or unable, compression only is great."

Clare, who is also the executive officer of training for St John's Ambulance in Queensland, says the study only examines adults and there are reasons that traditional CPR might be better where there are children involved.

"We'd prefer people to do traditional CPR, but any attempt to resuscitate is better than none," he says.

"So compression only, if the person is unwilling or unable is still a great option.

"Overall, when you look at kids in Australia, we have lots of instances related to drowning, because we're very much a coastal nation, those sorts of things - there's not enough proof yet that compression-only CPR has better outcomes in those circumstances.

"And in fact, some of the research - especially with children - is saying that, really, traditional CPR is what they need."

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