Cough CPR

The American Heart Association does not endorse "cough CPR," a coughing procedure widely publicized on the
Internet. As noted in the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care, the American Heart Association DOES NOT TEACH THIS AS PART OF THE CORE
During a sudden arrhythmia (abnormal heart rhythm), it may be possible for a conscious, responsive person to
cough forcefully and maintain enough blood flow to the brain to remain conscious for a few seconds until the
arrhythmia disappears or is treated. Blood flow is maintained by increased pressure in the chest that occurs during
forceful coughs. This has been mislabeled "cough CPR," although it's not a form of traditional resuscitation.

Why isn't "cough CPR" appropriate in CPR training courses?

"Cough CPR" should not be routinely taught in lay-rescuer CPR courses, because it would complicate teaching
traditional CPR. It would add information that's not generally useful in the prehospital setting. In virtually all
lay-rescuer CPR courses, the finding that signals an emergency is the victim's unresponsiveness. This signals the
rescuer to begin the "A, B, C's" of CPR. Unresponsive victims will not be able to perform "cough CPR."

Are there situations when "cough CPR" is appropriate?

This coughing technique to maintain blood flow during brief arrhythmias has been useful in the hospital, particularly
during cardiac catheterization. In such cases the patient's ECG is monitored continuously, and a physician is present.

During cardiac catheterization, patients may develop sudden arrhythmias. If a life-threatening arrhythmia is detected
within the first 10 to 15 seconds and before the patient loses consciousness, a physician or nurse may tell the
patient to cough. Repeated, forceful coughing can help the person stay conscious until the arrhythmia disappears or
is treated.

Therefore, the usefulness of "cough CPR" is generally limited to monitored patients with a witnessed arrest in the
hospital setting.

AHA Recommendation

The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them
by calling 9-1-1. If you're driving alone and you start having severe chest pain or discomfort that starts to spread into
your arm and up into your jaw (the scenario presented in the Internet article), pull over and flag down another
motorist for help or phone 9-1-1 on a cellular telephone.