The ‘kiss of life’ may not be such a lifesaver after all, say researchers at the University of Washington, Seattle.

Traditionally, accident victims suffering from cardiac arrest are given both cardiopulmonary resuscitation (CPR) and mouth to mouth ventilation to revive them. However, an unusual study has shown that CPR alone may be the key to survival (N Engl J Med, 2000; 342: 1546-53).

The researchers compared the outcome of 520 cases of cardiac arrest outside of hospital. In each case, a bystander was randomised to receive telephone instructions on how to revive the patient. Half were instructed to give CPR alone while the other half were told to use both CPR and mouth to mouth resuscitation.

Overall, 64 patients survived: 29 in the CPR with mouth to mouth group and 35 in the CPR only group. While the difference was not significant, it does give pause for thought.

The editorial which accompanied the study called it a “landmark study” which “will encourage efforts to reevaluate the way we teach and perform basic CPR”. The reason for the enthusiasm is that CPR with mouth to mouth resuscitation can be complicated for the average person to learn, retain and perform.

The possibility of removing one element of conventional resuscitation procedures means that resuscitation performed by a bystander may be less prone to error and more likely to be effective (N Engl J Med, 2000; 342: 1599-600).

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