Research since the 1960s has consistently confirmed that CPR is a vital holding manoeuvre to perfuse the heart and brain with oxygen, though it rarely itself restores circulation. At the time of CPR introduction to the community setting, out-of-hospital defibrillation was not developed, so the benefit of this holding manoeuvre would have been limited.
More recent research has confirmed that CPR plays another important role in prolonging the period of VF before deterioration into asystole (Holmberg et al. 2000). In one study shockable rhythms were present in 48% of witnessed out-of-hospital arrests where bystander CPR was being performed and in only 27% of cases where it was not (Dowie et al. 2003).
As discussed in the Chain of Survival (see Chapter 4), the question has arisen as to whether the lone rescuer should phone first or commence CPR. The evidence supports the recommendation for the lone rescuer to phone first prior to starting CPR. All healthcare professionals should be competent in performing CPR and should understand the rationale for seeking help first.
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