Evid Based Nurs doi:10.1136/eb-2013-101289
  • Primary health care
  • Cohort study

Another step towards the acceptance of chest compression only CPR for primary cardiac arrest

  1. Gordon A Ewy
  1. Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA
  1. Correspondence to: Dr Gordon A Ewy
    Department of Medicine, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, Arizona 85724, USA; gaewy{at}

Commentary on Iwami T, Kitamura T, Kawamura T, et al. Japanese Circulation Society Resuscitation Science Study (JCS-ReSS) Group. Chest compression-only cardiopulmonary resuscitation for out-of-hospital cardiac arrest with public-access defibrillation: a nationwide cohort study. Circulation 2012;126:2844–51.

Implications for practice and research

  • Out-of-hospital cardiac arrest (OHCA) is a major public health problem.

  • For decades, guidelines prescribed mouth-to-mouth (MTM) ventilation as the first step in resuscitation of both primary and secondary cardiac arrest.

  • The report by Iwami and associates is another observational study in patients that found improved survival of patients with primary OHCA who received chest compression only cardiopulmonary resuscitation (CO-CPR) by bystanders.1


Bystander-initiated MTM ventilation alternating with chest compressions was initially the standard, and has been in …

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