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Single-rescuer cardiopulmonary resuscitation: 'two quick breaths'—an oxymoron

Joseph W Heidenreich, Travis A Higdon, Karl B Kern, Arthur B Sanders, Robert A Berg, Rob Niebler, Jared Hendrickson, Gordon A Ewy
Resuscitation 2004, 62 (3): 283-9
15325447
The Guidelines 2000 for CPR and ECC recommend for single lay-rescuers performing basic life support, "two quick breaths followed by 15 chest compressions", repeated until professional help arrives. It is uncertain that this can actually be accomplished by the majority of lay rescuers. We evaluated 53 first-year medical students after completing BLS CPR training to determine if they could deliver the goal of 80 compressions per minute when following this AHA BLS recommendation. Alternatively, a simplified technique of uninterrupted chest compression (UCC) BLS CPR was also taught and compared with standard BLS CPR (STD). The mean number of chest compressions/minute delivered with AHA BLS CPR was only 43 +/- 1 immediately after initial training and 49 +/- 2 when tested 6 months later. Uninterrupted chest compression BLS resulted in 113 +/- 2 compressions/min delivered immediately after training and 91 +/- 4 six months later (STD versus UCC; P < 0.0001). The mean length of time needed to provide the two breaths during STD-CPR was 14 +/- 1 and 12 +/- 1s (immediately after first training and six months after training). For STD-CPR, the mean minute ventilation was poor immediately after initial training (3.3 +/- 0.3 l/min) and further declined (1.9 +/- 0.4 l/min) at 6 months (P = 0.003). For single rescuer basic cardiopulmonary resuscitation, motivated BLS CPR-trained medical students take nearly as long as previously reported for middle-aged lay individuals to deliver these "two quick breaths". The "Guidelines 2000" recommendation for "two quick breaths" is an oxymoron, as it averages more than 13s. New recommendations for single-rescuer CPR should be considered that emphasize uninterrupted chest compressions.

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