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What is Hands Only CPR?

In traditional CPR, the teaching had always been airway, breathing, and circulation.  However, recent guidelines by the American Heart Association are promoting a new way of approaching CPR, and it focuses on doing only compressions.  While CPR will stay the same within the confines of the medical profession, it is changing for the out of hospital, Good Samaritan responders.  With compressions only, some may wonder how effective CPR could be, but recent studies have shown that this method is just as effective as the old ABC version of CPR.

For medical professionals, this new development highlights how important compressions are when performing BLS.  If bystanders can get by with only doing compressions, then hospital BLS should focus on this part of the standard, as well.  In addition, hands only CPR makes it more attractive to bystanders who are usually less than willing to give mouth to mouth.  Comprising only one step to save a life, it is the newest and easiest way to treat cardiac arrest in the field and points to the importance of compressions in saving lives in any venue.

Hands Only CPR Explained

Hands only CPR is quite simple and just about anyone can do it.  In fact, you may not even need formal CPR training to understand how to do this type of resuscitation.  The rescuer starts compressions over the heart, at about the nipple line, and compresses at a regular rhythm.  Actually, the rhythm is similar to the beat in the popular song “Staying Alive.”  In essence, that is all the bystander needs to do until the ambulance shows up or an AED arrives.  It is so simple that many question how effective it could possibly be, but it helps to maintain brain and heart perfusion.

Of course, the depth of compressions and how to assess a passed out victim are still important, and this is why CPR should only be performed by those trained to do it.  Checking for breathing and checking for a pulse are vital before a bystander starts to pump on the chest.  If the person is down for another reason, the immediate initiation of chest compressions may make the situation worse.  For this reason, the public should still be encouraged to get CPR cards and to increase their knowledge of the use of emergency resources, such as 911 and AEDs.

Who Uses Hands Only CPR

The use of hands only CPR extends only to a few of the responders that would be rescuing a downed patient.  This type of CPR really only applies to those who are bystanders, don’t know CPR well, or are reluctant to perform rescue breaths.  Unfortunately, this is a large portion of the population when someone suffers a cardiac arrest out of hospital.  The American Heart Association is attempting to shine as much light on this form of CPR to get more people to participate if they should witness a cardiac event.

However, it should be noted that the Red Cross still feels that full CPR is better for the patient.  Although hands only CPR is a decent stopgap measure until the paramedics arrive, it isn’t a long term strategy for resuscitating a victim.  It should also be noted that even full CPR isn’t the definitive treatment for cardiac arrest, requiring at least defibrillation to reverse the condition.  This type of CPR is used by those who may not want to get involved or are squeamish about putting their mouth on someone else’s.  It is not for medical professionals who should always provide rescue breaths with a barrier or a bag-valve-mask.  This is the only way to ensure proper perfusion of target tissues.

How Effective is Hands Only CPR

Two studies have researched the effectiveness of hands only CPR.  Both studies appeared in the New England Journal of Medicine and had similar positive results.  Although they were conducted in different cities, the 911 dispatchers were instructed to give bystanders instructions for either traditional CPR or hands only CPR.  It was found that the rate of survival and brain damage between the two groups was remarkably similar.  In fact, both studies found no statistical difference between bystanders performing one or the other type of CPR.

For some, traditional CPR is the only acceptable form of resuscitation, and this is especially true for medical professionals.  If you know how to do CPR, you should give rescue breaths, whether you have a barrier or not.  However, some people don’t know CPR or don’t want to get involved in that issue, and hands only CPR is a great alternative until better help arrives.  It certainly is preferable to a bystander doing nothing while waiting for the ambulance.  In addition, two large, peer reviewed studies have shown that this form of CPR is just as effective as traditional CPR performed by amateurs.  This form should be made more public and encouraged, as it could save many lives if people are willing to act.


CNN; Hands-only CPR as effective as traditional, studies show; Caleb Hellerman; August 2, 2010