Last up in the news this week is a press release coming out of the American Heart Association regarding recommendations for compression only CPR. A review of the studies that led to that recommendation by a Swedish researcher shows that those studies largely looked at EMS systems in urban areas and that there is not enough research to support a hands only CPR approach for bystanders in rural or even suburban areas with longer response and transport times.

Rural Cardiac Care Time Constraints

CPRinAmbo_smThere were 10 studies that led to the original recommendations in the most recent 2010 ECC guidelines and only one of them looked at a system that could be considered rural or having a response time of greater than 15 minutes. In those situations, there is evidence, according to authors, that including respirations in bystander CPR was an important part of the survival curve.

More research is needed on this topic, certainly, but it points out that a “one size fits all” approach to care is not wise in EMS. What works for one part of the country in a given system may not work in other parts of the country. We are seeing this approach with the various community paramedic programs springing up out there. Each is developing their own procedures and operating guidelines as well as goals and benchmarks.

Every Patient, Every Call Different

This article is a reminder that every patient is different and, indeed, every patient population is different, too. While it’s important to watch what other EMTs and paramedics are doing with their patient care, we need to look at their success through the lens of how our system operates and what areas in it really need improvement or change.

Have you seen this in your area? I urge you to share your story here and I’ll post it on the MedicCast page so others can learn from you. That is the value of our community here on the MedicCast and I hope you’ll support it with your comments and input. Reach out to me by email at and let me know what’s going on in your system.


Follow-up on the link for this and other news items as well as all of the additional resource links in the show notes for this episode – Rural EMS Excellence and MedicCast Episode 334.


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