• I Virkkunen, S Kujala, S Ryynänen, A Vuori, V Pettilä, A Yli-Hankala, and T Silfvast.
• Department of Anaesthesia, Tampere University Hospital, Tampere, Finland. ilkka.virkkunen@uta.fi
• J. Intern. Med. 2006 Jul 1;260(1):39-42.

ObjectivesTo determine whether there is an association between bystander mouth-to-mouth ventilation and regurgitation in prehospital cardiac arrest patients.DesignProspectively conducted observational study.SettingData were collected from patients treated by the emergency medical service (EMS) systems in three middle-sized or large Finnish urban communities, the Tampere District EMS and the physician-staffed Helicopter EMSs in the Helsinki and Turku areas in southern Finland.SubjectsThe study population consisted of 529 consecutive prehospital cardiac arrest patients with attempted resuscitation. Exclusion criteria were cardiac arrest due to trauma or drug overdose.Main Outcome MeasuresRegurgitation in prehospital cardiac arrest patients documented by EMS personnel on the scene.ResultsRegurgitation occurred in a fourth of patients. Bystander cardiopulmonary resuscitation (CPR) with mouth-to-mouth ventilation was associated with a significantly increased risk of regurgitation compared with no CPR (P < 0.013) and CPR without ventilations (P < 0.01).ConclusionsThe mode and role of bystander CPR in cardiac arrest needs to be further evaluated.

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