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If a bystander sees an adult suddenly collapse and doesn't know how to administer cardiopulmonary resuscitation, chest compressions alone can be used to help, the American Heart Association says.

The recommendation is being published in this week's Circulation: Journal of the American Heart Association, and comes on the heels of three large separate studies last year describing outcomes after bystanders performed CPR on people suffering cardiac arrest.

The association says bystanders who don't know CPR should call 911, then do what's known as hands-only CPR, skipping the mouth-to-mouth portion of the life-saving technique.

"This involves providing high-quality chest compressions by pushing hard and fast in the middle of the victim's chest, without stopping until emergency medical services responders arrive," said Michael Sayre, a professor at The Ohio State University and chairman of the statement-writing committee, in a release.

An Edmonton doctor speaking for the Heart and Stroke Foundation of Canada says it's not a new recommendation, but rather an old recommendation with new evidence to support it.

"What we've been looking for in the last three years is evidence to support what we've been saying about 'do something as opposed to doing nothing,' " Allan de Caen said.

"We definitely have that literature now to say that doing something is better than doing nothing. I think that's what we've got that we didn't have in 2005."

North American population studies looking at CPR performed by bystanders have found that only between 20 per cent and 35 per cent of victims actually have any kind of CPR provided, Dr. de Caen said in an interview.

"It's the other 65 per cent that we're trying to make an impact with - either good standard CPR or at least chest-compression-only CPR."

But the foundation still wants people to enroll in conventional first-aid courses to learn the complete procedure, and Dr. de Caen said hands-only CPR is a default.

"The main message here is that we are trying to say it's okay if you get stuck - which is often where people have stumbled in the past, is people can't remember what to do, they're not sure what to do, they freeze," Dr. de Caen said.

"We're saying if you can't remember, if you don't know how to do the standard CPR, do at least this."

Beyond not knowing how to do full CPR, there are people who are reluctant to provide mouth-to-mouth resuscitation for a variety of reasons, said Michael West, a system control supervisor responsible for training and quality improvement at Toronto EMS.

When dispatchers have these people on the telephone line as they await emergency personnel, they are encouraged to carry on with life-saving techniques.

"If it's a family member they'll have no reservations whatsoever usually," Mr. West said.

"But it's usually the people who come across someone and they don't know them, they have no idea who they are, and basically they're trying to help a stranger, but they do have some limits that they'll go to."

Dispatchers recommend chest compressions because they're better than nothing, Mr. West said.

"Compressing the heart and continuing the blood flowing through the body has a great effect on the survivability of patients," he said.

"So what we would do in a case where a caller was reluctant to carry out the ventilation portion of the CPR instructions, we would then carry on and encourage them to do the compression component."