Hands-Only CPR facts: Is Bystander Issued Hands-Only CPR Useful?

The American Heart Association’s journal featured research by Swedish researchers on out-of-hospital cardiac arrest rescue.

The findings showed rates of bystander CPR went up almost twofold compression-only/Hands-only CPR increased sixfold over 18 years. Other hands only CPR facts showed the chances of living doubled for all forms of CPR compared to no CPR.

Following the increased adoption of hands-only CPR as a replacement to the standard CPR involving mouth-to-mouth and chest compression, the researchers studied the impact of the straightforward Hands-Only CPR approach and linked between the method of CPR performed and survival of the patient for 30 days.

A significant YOY Increase In CPR rates

“We spotted a noteworthy increase in CPR rates year over year, which can be linked to the higher rates of hands-only CPR,” said Gabriel Riva, M.D., Ph.D. Student at Stockholm-based Karolinska Institutet in Sweden. Gabriel, who is also the author of the study, said Bystanders have a critical role in saving lives at the risk of out-of-hospital cardiac arrest. “Their actions be lifesaving.”

“CPR, in essence, is simply a form of chest compressions. Compressing the chest alone doubles a victim’s survival chances compared to doing nothing,” said Gabriel.

According to Riva, though the Swedish guidelines promote CPR that focuses on rescue breathing, it is not clear whether this technique beats Hands-Only CPR done by bystanders. There’s an ongoing random test in Sweden trying to answer this question.

“Getting to the bottom of this is important because bystander-performed CPR before the arrival of emergency service is a critical determinant for survival in the event of an out-of-hospital attack. That explains why there’s a need to increase CPR rates by training more bystanders; it could lead to more survival,” he said.

In the United States, over 325,000 cardiac attacks occur out-of-hospital every year, according to stats by the American Heart Association. The department defines cardiac arrest as the sudden loss of heart function; it comes abruptly and may become fatal if precautionary steps are not taken immediately.

Hands only CPR statistics: The Study Scope and Research Findings

This study by the Swedish concentrated on bystander observed out-of-hospital cardiac attack involving 30,445 victims. Among them, 40 percent were not attended to by a bystander CPR while 39 percent were issued standard CPR.  20 percent of the patients received hands-only CPR.

The experts scrutinized three periods (2000 -2005), (2006-2010) and (2011-2017) — when the compression-only method of CPR was in practice within the Swedish CPR guidelines.

Here are the findings of the study:

  • The rates of Bystander CPR went up from 40.8% in 2000-2005 to 58.8% in 2006-2010 and again to 68.2% between 2011 and 2017.
  • Compression-only CPR increased from 5.4% in period 1, shot up to 14% period 2 and 30.1% in period 3.                    
  • The rates of Standard CPR were 35.4% within the first period, shot up to 44.8% in the second period and dropped to 38.1 percent between 2011 and 2017.
  • Cardiac arrest victims who received standard and compression-Only CPR were twice as much likely to survive 30 days, in contrast with patients who did not receive CPR for all the periods.

The limitation of the study was that it was based on observational data gathered during the third period and overtime, which comes with the possibility of miscalculation of rescue breaths and hands-only compressions before the arrival of emergency medical services and missing data of other variables. Plus, because the research was Sweden-based, they may not apply to other countries.

The results recommend and suggested hands-only CPR as a CPR method because it is linked with increased CPR rates and survival in out-of-hospital cardiac attacks. Plus, the data here is in line with previous findings in America and Japan.

According to the American Heart Association, instant CPR can triple or double your survival chances after cardiac attacks. This intervention keeps the blood flowing, which extends the chances of a successful resuscitation when medical staff set foot on site.

“We’ve noticed how sensitive bystanders are becoming when it comes to issuing CPR due to its benefits in saving the patient’s life, more so with Hands-Only CPR,” said Manny Medina, an AHA volunteer, and paramedic.

“Over the decade, I’ve heard stories of people of different ages train CPR and use their skills to save someone in the event of an attack. The process is easy to learn and continues to be a proven way to help people outside the hospital,” said Medina.


According to the Researchers, more study should be conducted to find out whether standard CPR that includes compression with hands and rescue breaths offers more significant benefit, in contrast with the compression-only CPR where the bystanders assisting have gone through training.