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Hands only CPR v CPR with rescue breaths

Much has been written and there are still many questions being asked about hands-only CPR and is it just as effective as conventional CPR with rescue breaths?

a person performing hands only CPR
hands only CPR

Is it OK to do hands-only CPR?

Is hands-only CPR better than full CPR?

What are the steps of hands-only CPR?


What is ‘hands only CPR’?


Hands only resuscitation, or compression only CPR, involves pushing hard and fast on the centre of the victim's chest and is recommended for use on teens or adults whom you see collapse.


Hands-only, or compression-only resuscitation, is a simplified form of cardiopulmonary resuscitation (CPR) that focuses solely on chest compressions without providing rescue breaths. This approach was introduced as a response to research findings and efforts to make CPR easier to perform effectively, especially by bystanders who may not have received formal CPR training.


Why ‘hands only CPR’?


The concept of compression-only CPR gained traction after several studies suggested that high-quality chest compressions are the most critical component of CPR in helping to maintain blood circulation and oxygen delivery to vital organs during cardiac arrest. These studies found that in the early minutes of cardiac arrest, effective chest compressions can significantly increase the chances of survival.

This is because when a teen or adult collapses with sudden cardiac arrest, they will still have oxygen in their blood stream and lungs.

By performing high quality compressions, a bystander can circulate this oxygenated blood to the vital organs which may delay the onset of brain damage caused by a lack of oxygen.


The American Heart Association (AHA) and other similar organisations initially promoted a combination of chest compressions and rescue breaths for CPR. However, in 2008, the AHA introduced guidelines that endorsed hands-only CPR for untrained bystanders or individuals who were unwilling or unable to provide rescue breaths. This was based on studies showing that even compressions alone could improve survival rates compared to no intervention at all.


Medical call takers would instruct untrained bystanders to push hard and fast on the persons chest continuously until help arrived if they were not confident or willing to deliver rescue breaths in a timely manner.


It’s not for everyone.


However, it's important to note that the effectiveness of hands-only CPR depends on the specific circumstances of the cardiac arrest event. In many cases, providing rescue breaths along with chest compressions may still be beneficial, particularly if the event has been ongoing for several minutes.


Rescue breaths help deliver oxygen to the lungs and maintain oxygen levels in the blood, which can be important for prolonged cardiac arrest situations.


For trained individuals, a combination of chest compressions and rescue breaths is still recommended, especially for longer durations of cardiac arrest.

The American Heart Association recommends it in cases where a bystander sees a teen or adult collapse.

CPR with rescue breaths is still recommended in all other circumstances such as.

· Respiratory conditions

· Drowning

· Choking

· Hanging

· Drug overdose

· As well as all incidents involving children or infants.


CPR Mechanisms and Blood Pressure Maintenance:


During cardiac arrest, the heart stops pumping blood effectively, leading to a rapid decline in blood pressure and oxygen supply to the brain. Once commenced, chest compressions, serve as a surrogate heartbeat. These compressions create artificial blood circulation, allowing the vital organs, including the brain, to receive oxygen. The rhythmic compressions manually pump blood from the heart to the arteries, thereby maintaining a minimum blood pressure to delay brain injury.


Preventing Brain Damage:

Studies have shown that each minute without effective CPR reduces the chances of survival by 7-10%. By maintaining blood pressure and adequate oxygenation, CPR prevents cerebral hypoxia, a condition resulting in oxygen deficiency in the brain tissue.


To breathe or not to breathe?


The Australian Resuscitation Council guideline 8 states “Cardiopulmonary resuscitation (CPR) is the technique of chest compressions combined with rescue breathing. The purpose of CPR is to temporarily maintain a circulation sufficient to preserve brain function until specialised treatment is available.”

“All rescuers perform chest compressions for all who are not breathing normally. Rescuers who are trained and willing to give rescue breaths are encouraged to do so.”


Yes, breathe.


As mammals we need oxygen and blood pressure to survive.

Cardiopulmonary resuscitation provides a small amount of both to a person in cardiac arrest.


The only question now is your willingness to provide it.

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