Statement on "Cough CPR"
(originally published April 2002)
Updated December 2005
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.
Reviewed August 2010
- Criley JM, Blaufuss JH, Kissel GL. Cough-induced cardiac compression: self-administered form of cardiopulmonary resuscitation. JAMA. 1976;236:1246-1250.
- Miller B, Cohen A, Serio A, Bettock D. Hemodynamics of cough cardiopulmonary resuscitation in a patient with sustained torsades de pointes/ventricular flutter. J Emerg Med. 1994;12:627-632.
- Petelenz T, Iwinski J, Chelbowczyx J, Czyx Z, Flak Z, Fiutowski L, Zaorski K, Petelenz T, Zeman S. Self-administered cough cardiopulmonary resuscitation (c-CPR) in patients threatened by MAS events of cardiovascular origin. Wiad Lek. 1998;51:326-336.
- Saba SE, David SW. Sustained consciousness during ventricular fibrillation: case report of cough cardiopulmonary resuscitation. Cathet Cardiovasc Diagn. 1996;37:47-48.