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Statement on "Cough CPR"
Updated December 2005
(originally published April 2002)
The BLS/AED Subcommittee has received a number of enquiries from people
who have been informed about "cough CPR" and "How to survive a heart attack when alone".
Advice has been put on the Internet that someone who thinks he or she is suffering a heart attack
should repeatedly cough and go at once to a hospital, by car if necessary.
This advice is based (very loosely) on published case reports of people
being able to maintain some sort of cardiac output during cardiac arrest by vigorous coughing
- so-called "cough CPR". The scenario has usually been of a patient developing ventricular fibrillation
whilst being monitored, often whilst undergoing cardiac catheterisation.
The patient has been encouraged to cough and a measurable circulation has been recorded.
This anecdotal evidence supports the theory that chest compressions during CPR are successful
because they increase intrathoracic pressure and result in a flow of blood.
The collapsed veins and patent arteries at the thoracic inlet result in this flow being in a forward direction.
Coughing produces the same effect.
The BLS/AED Subcommittee knows of no evidence that, even if a lone patient knew that cardiac arrest had occurred,
he or she would be able to maintain sufficient circulation to allow activity,
let alone driving to the hospital.
December 2005
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