To the Editor.—
The article by Cummins and Eisenberg1 in the April 26, 1985, issue of The Journal, "Prehospital Cardiopulmonary Resuscitation," confuses serious scientific questions with "irresponsible" assaults on a "national institution," that is, cardiopulmonary resuscitation (CPR). Moreover, their review omits large patient data bases that are not as favorable to conventional CPR as those presented.Cummins and Eisenberg included series totaling 2,558 patients in their review (some series as small as 19 patients) in support of their claim of positive results with conventional CPR. However, there are at least four other significant studies totaling nearly 4,200 patients, the results of which are appropriate for scientific criticism of their thesis.
Mirick et al2 in 1982 reported on 98 Minneapolis patients in whom they could find no significant effect of bystander CPR.
Kowalski et al3 reported on 363 patients with ventricular fibrillation in the Milwaukee County paramedic system. Resuscitation