To the Editor: Dr Bobrow and colleagues1 reported the results of an intensive statewide educational program of COCPR in Arizona over a 5-year period. They found an increased overall survival but excluded 297 patients younger than 18 years, as well as 1128 patients with noncardiac causes for whom a combination of chest compressions with ventilations is specifically recommended.2,3 These patients should have been included in the overall analysis because this community educational program increased awareness and use of COCPR (+25%, from 5% in 2005 to 30% in 2009) but decreased use of conventional CPR (−13%, from 23% in 2005 to 10% in 2009), with potential adverse effects on outcome for the excluded patients. The reported similarity of survival does not refute that possibility because of small numbers.
Koster RW. Survival From Out-of-Hospital Cardiac Arrest After Chest Compression–Only CPR. JAMA. 2011;305(2):147-148. doi:10.1001/jama.2010.1952