PhotoYou're waiting at a bus stop when the person standing next to clutches his chest and keels over.

What do you do? If you have been trained in CPR and administer it to the poor fellow, and paramedics quickly arrive on the scene, chances are he'll be okay.

At least that's the conclusion of new research from Duke University, which studied whether CPR administered by a bystander made a difference in whether someone suffering from cardiac arrest survived. They found that it did.

“We were surprised to learn that survival increased only for those who received bystander-initiated CPR, compared with those who did not receive bystander-initiated CPR,” said lead author Carolina Malta Hansen, of the Duke Clinical Research Institute. “Also, patients who received bystander or first-responder CPR and defibrillation were more likely to survive compared to those who received CPR and defibrillation once EMS arrived. This suggests that the very earliest intervention is crucial, and is something anyone can do. It saves lives.”

Previous research

Japanese researchers reached a somewhat similar conclusion in 2013. They found that performing CPR on a heart attack victim for 38 minutes or longer can improve a patient’s chance of survival. It also improves the chances that survivors will have normal brain function, researchers said.

The common thread appears to be the importance of an immediate response. After allowing for other factors that can affect neurological outcomes, the Japanese researchers found that the odds of surviving an out-of-hospital cardiac arrest without severe brain damage dropped 5% for every 60 seconds that passed before normal blood circulation was restored.

Sudden cardiac arrest kills an estimated 200,000 people a year in the U.S., making it one of the leading causes of death. Senior author of the Duke study, Christopher Granger, says the data he and the research team examined showed that there has been more bystander-initiated CPR in recent years.

“During the past decade, there has been a focus on increasing bystander CPR,” he said. “Our findings show that survival can be improved by strengthening first-responder programs and encouraging more bystander CPR.”

Where to learn

In recent years doctors have concluded that mouth-to-mouth resuscitation is not necessary, that chest-compression CPR is more effective. There are many places to learn the technique, but YouTube is not one of them.

Researchers writing in the October 2014 issue of Emergency Medicine Australasia investigated the accuracy of YouTube videos on CPR, checking them against the 2010 CPR guidelines.

It concluded that the majority of YouTube video clips purporting to be about CPR are not relevant educational material. Of those that are focused on teaching CPR, only a small minority optimally meet the 2010 guidelines, the study found.

That's not to say there isn't reliable, relevant information on the Internet. The trouble is finding it.

You can usually trust CPR instructions from major health institutions like the Mayo Clinic. Your local branch of the Red Cross likely offers free training classes as well.


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