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Hands-only CPR greatly increases survival odds

Rating

4 Star

Hands-only CPR greatly increases survival odds

Our Review Summary

This article summarizes recent research and expert opinion about new guidelines on bystanders’ use of hands-only cardiopulmonary resuscitation (CPR) to treat victims of cardiac arrest. Overall, the story covers the topic well. However, it could offer readers just a bit more about the nature and strength of the evidence showing that hands-on CPR is as effective as standard CPR (which includes mouth-to-mouth resuscitation). The evidence comes from a mix of retrospective and prospective studies that are necessarily observational (not randomized controlled studies) and report the outcomes of bystanders’ attempts to revive someone suddenly stricken down. The studies are quite large, and involve hundreds and sometimes thousands of patients in different parts of the world. The news story could also fine-tune its discussion of the potential benefits of expanded use of hands-only CPR. Quantifying this benefit is surely tricky, but the current account provides inexact estimates without explaining the uncertainty surrounding them.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

The news story does not mention costs, but a discussion of cost is relatively unimportant in the context of this story.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The article says that CPR in any form "may double the rate of survival from cardiac rest." According to a spokesperson for the American Heart Association, this means that “we can save tens of thousands of lives.”  Later in the story the spokesperson is reported as saying that when more people use CPR in cities such as Seattle, survival rates have jumped to as high as 30%. An AHA scientific statement says cities such as Seattle have reported survival of “more than 15%.” It adds that hands-only CPR and other changes (e.g. dispatcher-assisted "telephone" CPR) could save "thousands of additional lives" every year." This mix of relative and absolute estimates suggest there is surely some real benefit to increasing the use of CPR, but the precise amount of that benefit remains a bit fuzzy.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The news article explains that when CPR is performed with chest compressions only (without mouth-to-mouth resuscitation) the main harm is rib fractures induced by energetic chest thumping.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

Although the story mentions that "3 major studies published last year" provide evidence to support the new AHA recommendations on CPR, it fails to discuss the quality of this evidence. The studies comparing survival after bystanders’ use of hand-only vs. standard CPR are necessarily observational. The story could have explained the possible limitation of such studies.

Does the story commit disease-mongering?

Satisfactory

The article explains that a tiny minority of people who need CPR actually receive it. It also reassures readers that untrained bystanders can perform CPR and potentially save lives. The story does not exaggerate the problem of untreated cardiac arrest.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The article cites three sources, two of them associated with the American Heart Association (which developed the new guidelines) and one an apparently independent expert who supports the guidelines.

Does the story compare the new approach with existing alternatives?

Satisfactory

The article discusses hands-only and mouth-to-mouth resuscitation, and explains that these are used while bystanders await other options—usually treatment by emergency medical personnel and/or automated external defibrillator and, ultimately, hospital medical staff.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The news article makes it clear that virtually anyone can perform hands-only cardiopulmonary resuscitation (CPR). It requires no devices or drugs. The major barrier to treatment appears to be fear–of harm to the victim or rescuer, and/or and fear of failing to perform CPR correctly.

Does the story establish the true novelty of the approach?

Satisfactory

The article points out that CPR has been taught in first-aid classes for more than 40 years.

Does the story appear to rely solely or largely on a news release?

Satisfactory

There is no evidence that the story relied solely or largely on a press release.

Total Score: 7 of 9 Satisfactory

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