AHA's 'hands-only' guidelines might not be best for rural areas though. According to new research, Hands-only CPR (CPR without mouth-to-mouth resuscitation), might not be the most effective technique for rural or remote areas or for anyone who needs to wait quite a few minutes for an ambulance. Literature reviewed by Dr. Aaron Orkin found very little evidence to support those guidelines outside of urban settings or in communities with no 911 services. His findings were revealed in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
Of the ten studies on saving lives with hands-only CPR he reviewed, only 1 included rural populations and people who had to wait longer than 15 minutes for an ambulance. a number of those studies showed that folks who waited longer for ambulances to arrive had a stronger likelihood of survival if mouth-to-mouth respiration was performed in addition to chest compressions. "Urban studies can't always be applied outside big cities," said Dr. Orkin, a doctor and graduate student attached with the University of Toronto, "Rural communities might need different CPR recommendations than urban settings," he said.