The current AHA-ECC guidelines for basic life support focus on the provision of good chest compressions with minimal interruptions for patients with presumed out-of-hospital cardiac arrest. Moreover, international consensus guidelines now support the use of chest compression-only cardiopulmonary resuscitation (CPR) instructions for dispatcher-assisted CPR given over the phone to untrained bystanders. However, evidence that strongly challenge these recommendations have been overlooked. A review of this evidence argues for the need for head rotation (a hands-free method of airway control) and abdominal compressions during bystander CPR.