To the Editor.—
The enthusiastic training of lay persons in cardiopulmonary resuscitation (CPR) is a legitimate national priority. Some inherent complications of such instruction might be averted by slight modifications of the teaching techniques. Most instructors are familiar with muscle sprains in the lower area of the back and in the neck and infection from improperly cleaned mannikins used for demonstrating mouth-to-mouth respiration. More recently, I have encountered acute temporomandibular arthropathy occurring several days after CPR instruction and vigorous simulated mouth-to-mouth breathing. The patient required several lidocainesteroid injections for relief.Other side effects of CPR training undoubtedly have been encountered, especially among relatively sedentary volunteers. In view of the highly litiginous nature of our society, such complications could have medicolegal ramifications—notwithstanding the altruistic intent underlying CPR instruction.