Compression only CPR



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  1. This month has seen the introduction of several advertisements from the British Heart Foundation about performing Hands-Only CPR.
    The adverts feature on-screen hard-man Vinnie Jones and follow him as he performs life-saving Hands-Only CPR on a cardiac arrest victim.
    The BHF are now advising that during CPR, anyone who is untrained should perform only chest compressions rather than also giving rescue breaths. The campaign comes as a result of research carried out by the BHF which shows that many untrained people are afraid of giving rescue breaths to a casualty and consequently would not attempt CPR at all, if the situation arose. However, it is important to remind students that also giving rescue breaths remains the “gold standard” of CPR. Anyone who is trained and confident in performing CPR should continue to follow the guidance of giving chest compressions AND rescue breaths, at a ratio of 30 to 2.

    The Theory of Hands-Only CPR
    The theory behind Hands-Only CPR is that if an ADULT casualty has a cardiac arrest outside hospital, it’s usually a heart problem (e.g. heart attack) that has caused it. In that scenario, the blood is usually full of oxygen at the time that the heart stops, so the immediate need is not to give breaths, but to pump the blood around (circulating the oxygen that is already there). In cardiac arrest the body uses up much less oxygen, so some studies have shown that the body can last for up to 5 minutes on the oxygen left in the blood if it is pumped around. There is an added benefit that it’s very easy to learn and you won’t be put off by having to “kiss” them, so more people will attempt it, and it’s much, much better than doing nothing at all.

    There are a couple of limitations to Hands-Only CPR however:
    1) If the cause of the cardiac arrest is NOT a heart problem (e.g. drowning) or if the casualty is a CHILD, then it’s likely that there is a huge lack of oxygen in the blood by the time the heart stops, so this time the casualty will be desperate for some rescue breaths. In children, the likely cause will be something to do with breathing, such as an asthma attack or choking.
    2) Ambulances often take longer than 5 minutes to arrive (current government targets are for 75% of ambulances to arrive in 8 minutes).
    For those reasons, the gold standard is to give compressions AND rescue breaths, at a ratio of 30 to 2.

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