Comparison of prehospital conventional and simultaneous compression-ventilation cardiopulmonary resuscitation

Abstract

Nine hundred ninety-four patients were enrolled in a field trial in which ambulance crews were randomly assigned to use simultaneous compression-ventilation (SC-V) CPR or conventional CPR procedures in the prehospital setting. Survival to hospital admission and to discharge was superior in the conventional CPR group vs. the experimental group (p less than .01). In a subset of adult cases whose causes of arrest were nontraumatic, survivor rates still favored the conventional CPR group: 33.5% of 337 vs. 22.5% of 365 (p less than .001). In limited cases where cardiac arrest was due to other heart disease, was vascular in origin or secondary to other natural diseases or from hypertensive cardiovascular disease, or when ECG on arrival was an agonal rhythm, survival was better (but not statistically significantly) in the experimental group. There were no statistically significant differences in the Glasgow coma scores between surviving patients in either group at 24 h post-hospital admission or discharge. It is concluded that survival in the SC-V CPR group was lower, likely reflecting a deleterious effect of the experimental technique of resuscitation. Also noted was that 14% of the control patients and 6% of the experimental patients survived with manual CPR alone.