Cough CPR

Cough CPR is a fake resuscitation technique described in an email that began circulating around 1999, in which by coughing and deep breathing every 2 seconds a person suffering a cardiac dysrhythmia immediately before cardiac arrest can supposedly keep conscious until help arrives (or until the person can get to the nearest hospital). Cough CPR is most likely a lay interpretation of a "Vagal Maneuver". A vagal maneuver is a technique where a person bears down (as if trying to forcefully pass wind) to stimulate the vagus nerve. This is helpful in cases when a person experiences a dysrhythmia such as Supraventricular Tachycardia (SVT). The vagal nerve stimulation sometimes can slow down the rapid heart rate and convert SVT back to a normal sinus rhythm.

Although the vagal maneuver is in fact taught to doctors, nurses and paramedics, this widely-circulated email confuses the difference between a "heart attack" and a "cardiac arrest" and cardiac dysrhythmia. Cough CPR is supposedly intended only for imminent cardiac arrest, yet it would be impossible for anyone to know if cardiac arrest was imminent. Neither the American Heart Association nor the American Red Cross endorses cough CPR during a heart attack..

This confusion appears to revolve primarily over the public's failure to discriminate between a heart attack and cardiac arrest and cardiac dysrhythmias. A heart attack occurs when an occlusion (e.g. blood clot) of an artery in the heart slowly causes tissue to die. This can result in chest pain and discomfort, and requires immediate medical attention to resolve the occlusion by emergency surgery or cardiac clot-busting drugs. A cardiac dysrhythmia is primarily an electrical problem within the heart, and is sometimes treated with electrolytes, vagal maneuver, or electrical cardioversion. Many dysrhythmias may herald an impending heart attack.

"Cardiac arrest" occurs when the heart stops beating, usually due to a heart attack, other prior medical condition or disturbance of the heart's electrical system. "Cough CPR" is intended not for a heart attack, but rather, imminent cardiac arrest. The author of the email attests that coughing can increase blood pressure to the brain, preventing the person from fully arresting, though there is no scientific evidence that increased blood to the brain prevents cardiac arrest. Most people cannot identify when they are about to go into cardiac arrest even if they are monitored by an electrocardiogram at a hospital. The American Heart Association does not recommend Cough CPR even when a patient is monitored by an electrocardiogram with imminent signs of cardiac arrest.

Many experts are deeply concerned that people experiencing a heart attack may attempt to perform Cough CPR before attempting to call for emergency medical assistance first. The action of coughing itself may worsen myocardial ischemia and infarction (i.e. worsen a heart attack) due to the breath holding individuals experience while trying to cough, preventing the inhalation of oxygen.