PERHAPS no one intervention is as divisive as cardiopulmonary resuscitation, often abbreviated to CPR.

Heart charities and similar organisations will advise that everyone should learn CPR. A recent poll by the British Heart Foundation (BHF) showed that just over half of those asked would be confident to perform CPR, should the need arise.

A third had never learned CPR. Of these, almost half sited they didn’t know where to go to find out, and a quarter arguing they lacked the faith in themselves to be able to master the techniques.

In the UK there are around 30,000 out of hospital cardiac arrests a year.

Statistics for survival remain at best dismal. Fewer than 10 per cent survive the initial arrest. Of those in whom resuscitation is attempted, less than one in 12 will survive to hospital discharge.

Although it may sound laughable, this is very much at odds with images portrayed on television, where roughly three quarters of those who undergo cardiac arrest make a recovery.

CPR is not a new concept. It was described initially by the ancient Greeks. In 1878 the technique of pumping the chest of cats whose hearts had stopped beating, was shown to restore circulation.

Yet it was not until 1959 that researchers at John Hopkins University applied these findings to humans.

Since the 1970s public classes have been made available for anyone interested. Indeed, now certain professions other than healthcare providers are expected to have basic proficiency not only in chest compressions, but also know how to use a defibrillator.

It would be very difficult to argue that this was not an excellent initiative. Time really is of the essence when a person’s heart or lungs stop. Statistics highlighted by the National Institute for Health and Care Excellence (NICE) show that if CPR is commenced immediately, this can increase survival after an out of hospital cardiac arrest by up to fourfold.

The prompt application of a defibrillator within three to five minutes may increase survival by up to 70 per cent.

With defibrillators a regular part of the scenery in the same manner as post-boxes, we owe it to ourselves to have a basic working knowledge, should the need arise.

However, a balanced article on resuscitation also needs to highlight the other side of the argument.

The most important consideration is “why has the person arrested?” In younger individuals, it is more likely that there is a reversible cause. This is particularly pertinent in cases of drowning or hypothermia.

Yet in older individuals, it is often the case that their heart or lungs have stopped working as this is the end of their natural life.

While television would have us believe that everyone who arrests will be miraculously brought back to life and in fine fettle, the statistics above show the stark reality of the situation.

There is also the burning question that even if you can perform CPR, how long should you go on for? The whole idea of CPR is to provide adequate circulation through chest compressions, and oxygen through mouth to mouth, that the victim gets enough blood to their vital organs, particularly their brain.

Even in the most experienced of hands, CPR is estimated to be only 25per cent as effective as the heart beating spontaneously.

Prolonged CPR can be both physically and psychologically traumatic for the victim and those performing chest compressions and mouth to mouth. It is in essence a fairly brutal method, in the worst of situations.

If the call is made, many emergency services will reach the casualty in good time, although this is not always the case. Think of arrests in remote places, or where there is only one person present to resuscitate the individual.

It is important to recognise when to give up, which is often difficult for non-healthcare professionals.

For anyone interested in learning more about CPR, there are an abundance of courses, both online and in person. The British Heat Foundation has a 15-minute online course where the only equipment you need are a mobile phone and a chest cushion to practice on.

Though a discussion of resuscitation techniques is beyond the scope of this article, there are two take-home messages. Please always approach any victim with caution. Be alert for anything that may injure you as your safety is a priority. Secondly, when performing CPR, if you are alone and you become exhausted, it is acceptable to stop.

Useful websites:

resus.org.uk

bhf.org.uk

sja.org.uk