Resuscitation Council UK’s statement on cough CPR

Resuscitation Council UK has received enquiries from people who have read, usually on the Internet, about ‘Cough CPR’ and ‘How to survive a heart attack when alone’. 

Resuscitation Council UK is concerned by such incorrect ‘advice’ which recommends that someone who is on their own and thinks they are having a ‘heart attack’ should cough repeatedly and – whilst continuing to do that – get themselves at once to a hospital, by car if necessary. Cardiopulmonary resuscitation (CPR) is the correct treatment for sudden cardiac arrest, which is when the heart suddenly stops pumping. The majority of people having a heart attack will not suffer a cardiac arrest, and by attempting ‘cough CPR’ they could make their condition worse. 
 
The incorrect ‘advice’ has probably been based (very loosely) on a few published case reports of people with sudden cardiac arrest being able to maintain a heartbeat, and therefore a circulation, by repeated vigorous coughing - so-called ‘cough CPR’. However, this has been achieved in hospitals, during tests or treatment on the heart in which the person was being monitored closely and supervised by doctors throughout. 

Cardiac arrest usually causes loss of consciousness within a matter of seconds, giving a person no warning. Even if a person suspected that they were having a cardiac arrest, it is highly unlikely that coughing could maintain enough circulation to do anything else, let alone drive safely. The correct advice for anyone who thinks they may be having a heart attack is to call immediately for an emergency ambulance and, whilst waiting for the ambulance to arrive, follow advice from the ambulance call handler. 
 
Free resources for learning more about CPR are available, including digital game-in-a-films Lifesaver and Lifesaver VR which teach people effective CPR skills and provide them with the confidence to put them into practice.  

  1. Criley JM, Blaufuss JH, Kissel GL. Cough-induced cardiac compression: self-administered form of cardiopulmonary resuscitation. JAMA. 1976;236:1246-1250.
  2. 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.
  3. Saba SE, David SW. Sustained consciousness during ventricular fibrillation: case report of cough cardiopulmonary resuscitation. Cathet Cardiovasc Diagn. 1996; 37:47-48
  4. 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. 
  5. American Heart Association. Cough CPR. 10 March 2017. http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/Cough-CPR_UCM_432380_Article.jsp#.W0IE8dK2m9I  (accessed 08 July 2018).

Previous editions: 2002; 2005, 2010, 2015. Revised July 2018