Stone Age CPR

Philip J. Goscienski, M.D.

May 2011

Cardiopulmonary resuscitation (CPR) is barely out of the Stone Age. The current method of mouth-to-mouth breathing and chest compressions has been taught for only 50 years and the first automated external defibrillator (AED) was deployed in Seattle a little more than 25 years ago.

Approximately 1,000 Americans die each day from sudden cardiac arrest (SCA) and for about half of them death is the first symptom of heart disease. Without immediate CPR and rapid defibrillation, the survival rate is less than 5 percent. For every minute that passes between cardiac arrest and defibrillation, the likelihood of survival falls by about 10 percent.

In communities that have deployed AEDs widely the survival rate from cardiac arrest has risen from less than 5 percent to more than 50 percent. The "save" rate at some city airports, such as San Diego, is over 70 percent. If the pharmaceutical industry were to release a drug that improved survival for any condition by a factor of more than 10 it would make the headlines for days. This is what the AED does but it has received much less attention than it deserves.

Persons who have never learned how to use an AED have saved lives because voice prompts guide every step. Once the device is turned on and the palm-sized electrode pads have been placed on the victim's bare chest, as shown by diagrams on the pads, the AED determines the need for a shock. Some models deliver the shock automatically; some require the operator to push a flashing button. It is not possible for the operator to override the AED's decision by shocking the victim when it is not indicated. As to potential harm, those who proselytize for its use note that the only way to injure someone with an AED is to hit them over the head with it.

Legal issues are no barrier. Establishments without an AED are at risk of litigation. No person or business has been successfully sued for having an AED that is properly maintained and readily available.

CPR training is inexpensive and new teaching methods make it easy to learn. The recent emphasis on chest compressions only, with no immediate mouth-to-mouth breathing, removes a major barrier to bystander participation in this lifesaving process. Your local American Heart Association or American Red Cross office can direct you to a course. There is no excuse for not being prepared to save a life.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at