Clarification Statement on Cardiopulmonary Resuscitation for Drowning

The ILS urgently reminds all would-be rescuers that hands-only CPR is not appropriate in cases of drowning.

The American Heart Association (AHA) Emergency Cardiovascular Care (ECC) Committee has recently published a statement on cardiopulmonary resuscitation (CPR).

This recommends that bystanders who witness an adult suddenly collapsing out of hospital should perform chest compressions only without giving mouth-to-mouth ventilation, so-called hands-only CPR.

Drowning is the second leading cause of accidental death worldwide. While hands-only CPR may be effective in cases of sudden heart attack, cardiac arrest during drowning is due, in large part, to lack of oxygen. The body is thus starved of oxygen and needs urgent replenishment in addition to circulation of blood that is provided by chest compressions.

Similarly, compression-only CPR is inappropriate in cases of cardiac arrest in children, when failure of breathing is the usual underlying cause.

The AHA ECC Committee statement includes: “this call to action for bystanders does NOT apply to unwitnessed cardiac arrest, cardiac arrest in children or cardiac arrest presumed to be of non-cardiac origin”. The ILS concurs with this, but is concerned that the overwhelming emphasis on hands-only (compression-only) CPR in the statement will mean that this secondary advice may be overlooked.

Further information can be found in the Medical section of the ILS website. In particular, attention is drawn to the Medical Position Statements on Critical CPR Skills, Use of Oxygen, and In-Water Resuscitation.

For more information, please contact ILS.

Issued 3 April by the ILS Medical Committee: Dr Stephen Beerman MD, Prof Joost Bierens MD, Dr Zaid Chelvaraj MD, Dr Phillip Dickinson MD, Dr Anthony Handley MD, Prof John Pearn MD, Angela Lawson, Dr David Szpilman MD and Dr Peter Wernicki MD