Out-of-hospital cardiac arrest (OHCA) is a common occurrence in the UK, with 60,000 cases reported annually. To improve outcomes among these patients it is necessary to improve links in the cardiac arrest chain of survival. Cardiopulmonary resuscitation (CPR) is one of the main elements of this chain because it reduces further ischaemic insult in the brain and heart by contributing to blood flow. However, even the best manual CPR provides only 20%-30% of the normal cardiac output. Despite the emphasis on timely CPR at the correct rate and depth, delivery of compressions is suboptimal for many patients and mechanical devices may improve outcomes.

This article critically appraises two important papers on the use of mechanical CPR for OHCA. It also suggests potential uses for this treatment option and areas for future research.