[Lay-rescuer cardiopulmonary resuscitation (CPR)--controversies in emergency medicine: lay-rescuer CPR with or without mouth-to-mouth ventilation].

An analysis of literature results reveals differences concerning the need for rescue breathing in lay-rescuer cardiopulmonary-resuscitation (CPR). Observational studies on large registries have shown improved survival rates with standard CPR (chest compressions and rescue breathing) compared to continuous chest compressions (CCC). This applies especially for cardiac arrests of non-cardiac origin or prolonged EMS-arrival times. In contrast a public program for lay-rescuers focusing on CCC lead to improved success rates of bystander-CPR, followed by improved survival rates. The 2010 ERC guidelines have resolved this controversy by integrating both aspects. CCC is recommended for everyone. Trained bystanders should use standard-CPR as method of choice. For dispatcher-assisted CPR the results are clear. Giving instructions for mouth-to-mouth ventilation is too complicated and time consuming, thus impairing survival rates. Therefore CCC is recommended for dispatcher-assisted CPR.