The literature related to the rationale of cardiopulmonary resuscitation (CPR) including chest compressions combined with ventilations or compression-only CPR without ventilations is reviewed.
The conclusion is that the evidence in favor of compression-only CPR is of limited level of evidence and does not convincingly support the superiority of compressions without ventilations, nor does it prove its non-inferiority. Theoretical and practical considerations favor continued education in the combined application of chest compressions and ventilations with a compression:ventilation ratio of 30:2.
Compression-only CPR should be recommended only if the rescuer is not willing or able to deliver mouth-to-mouth ventilation or when CPR is instructed by the dispatcher to untrained rescuers by telephone. For all other circumstances, trained rescuers should combine chest compressions with ventilations.