Abdominal binding and counterpulsation in cardiopulmonary resuscitation

During the past 15 years, many different studies have documented improved blood pressure and blood flow above the diaphragm when some type of abdominal compression was added to conventional CPR, either in animals or in humans. Rhythmically interposed abdominal compressions seem to provide even greater hemodynamic benefit than continuous abdominal binding. Both total flow and the distribution of flow to vital organs above the diaphragm are improved, while the chances of liver entrapment and damage during chest compression are reduced. The technique of interposed abdominal compression can be performed with the bare hands of a second or third rescuer. It requires no special equipment, and could be easily incorporated into existing training programs for basic rescuers. In this sense the technique may constitute a logical evolution in basic life support, if subsequent clinical research confirms that it improves outcome.