More compressions, fewer interruptions lead to higher cardiac arrest survival

May 04, 2009

Survival rates from out-of-hospital sudden cardiac arrest almost doubled when professional rescuers using cardiopulmonary resuscitation (CPR) gave better chest compressions and minimized interruptions to them, according to research reported in Circulation: Journal of the American Heart Association.

"It's a back-to-basics message. Even with professional rescuers, starting IVs and delivering medications can take a back seat to good quality chest compressions," said Alex G. Garza, M.D., M.P.H., lead author of the study and associate professor of emergency medicine at the Washington Hospital Center and Georgetown University School of Medicine in Washington, D.C.

Garza's study tracked results from changes in resuscitation protocols implemented by the Kansas City (EMS) in 2006. The Kansas City EMS put the highest priority on hands-on time to provide chest compressions with limited interruptions. Rescuers performed 50 chest compressions before pausing to provide two breaths. (American Heart Association guidelines call for 30 compressions followed by two breaths.) Other changes included the rescuers delaying intubating the patient and administering medications.

Overall survival from out-of-hospital increased from 7.5 percent to 13.9 percent after the EMS department made the changes to its resuscitation practices.

Comparing the 36 months prior to the protocol shift with the 12 months afterwards, the researchers also found:

  • Of patients whose cardiac arrest was witnessed by bystanders and who were initially in ventricular fibrillation, the success of resuscitation in restoring a and getting the patient to the hospital alive improved from 37.8 percent (54 of 143) to 59.6 percent (34 of 57 patients).
  • Of patients whose cardiac arrest was witnessed by bystanders and who were in ventricular fibrillation, survival to hospital discharge rose from 22.4 percent (32 of 143) to 43.9 percent (25 of 57).
  • Of the 25 discharged patients, 88 percent scored well on measures of brain function.
"It takes five to seven chest compressions to raise the pressure enough to begin driving blood into the heart tissue," Garza said. "If you stop too often to provide a couple of breaths, then you haven't helped the heart much and you have to start building pressure all over again."

Nearly 300,000 sudden cardiac arrest (SCA) victims are treated by EMS in the United States each year, according to the American Heart Association. SCA is an abrupt loss of heart function; it usually occurs after the heart's electrical impulses become rapid or erratic, preventing the heart from effectively pumping blood.

"In that five- to 10-minute period after an SCA, a lot of evidence shows that if you do chest compressions to keep blood going to the heart muscle, defibrillation is far more likely to work," Garza said.

Source: American Heart Association (news : web)

Explore further: Syria hit by flesh-eating maggot disease

add to favorites email to friend print save as pdf

Related Stories

New studies confirm chest compressions alone

Dec 26, 2007

Two large-scale studies published in the Dec. 18 issue of the American Heart Association’s medical journal, Circulation, report that the chances of surviving cardiac arrest are no better – and may be worse – when b ...

Post-cardiac arrest care key to survival

Oct 23, 2008

The urgent need for treatment doesn't end when a person regains a pulse after suffering sudden cardiac arrest — healthcare providers need to move quickly into post-cardiac arrest care to keep a person alive and ensure the ...

Recommended for you

Syria hit by flesh-eating maggot disease

15 hours ago

Three cases of myiasis have been reported near Damascus, marking the first appearance of the flesh-eating maggot disease in Syria, UN health experts said Friday.

Sperm can carry Ebola for 82 days: WHO

17 hours ago

Sperm can carry the Ebola virus for at least 82 days, the World Health Organization said Friday, urging men recovering from the disease to use condoms for three months after the onset of symptoms.

User comments : 2

Adjust slider to filter visible comments by rank

Display comments: newest first

MadLintElf
not rated yet May 05, 2009
I also remember reading (on physorg) that by not introducing too much O2 and more CO2, then slowly switch them, they had higher rates of recovery.

Apparently putting the O2 back in the blood stream too fast causes cell death, whereas putting it back slowly with higher concentrations of CO2, helped to keep cell death rates down.

Cheers
MadLintElf
not rated yet May 05, 2009
Found a link to the above article, it's at...

http://www.damnin...m/?p=860

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.