Chest Compression Only Cardiopulmonary Resuscitation (CCO-CPR) in out-of-hospital cardiac arrest and low resource setting - a case report

Statement of the problem: Out-of-hospital cardiac arrest (OHCA) often occurs in our population, but is rarely reported. Chest compression only (CCO) has been emphasized to manage such conditions by the lay rescuers and not by the trained expert who is unwilling to give mouth-to-mouth rescue breathing.Objective: To demonstrate the usefulness of Chest Compression Only Cardiopulmonary Resuscitation (CCO-CPR) by a bystander rescuer and potentially a CPR expert, who was not willing to give mouth-to-mouth rescue breathing in out-of hospital cardiac arrest.Summary: We report the case of a 50-year-old woman with cardiac arrest in out-of-hospital setting. She was hit by a moving vehicle at her road-side shop. Coincidentally, a bystander rescuer (an Anaesthetist) who witnessed the accident attended to the victim and diagnosed cardiac arrest. CCO-CPR was commenced by the rescuer who had no CPR adjuncts or drugs. The rescuer was also unwilling to give mouth-to-mouth rescue breathing. The patient's respiratory efforts and carotid pulsations returned after about 7 minutes of commencement of CCO-CPR although the patient was still unconscious. She was thereafter rushed to a nearby hospital where she was admitted and treated definitively. She fully regained her consciousness few minutes after admission. She was observed for 24 hours and discharged home in good clinical condition.Conclusion: This case is reported to sensitize health-care givers that Chest compression only CPR could be life saving in the hand of a bystander rescuer who is not willing to give mouth-to-mouth respiration