Improved CPR for Some Situations

The important outcome for any cardiopulmonary resuscitation (CPR) attempt is survival of the patient, so any changes that seem to improve the survival rate must betaken seriously. A new approach developed by the Wisconsin Emergency Medical Services together with the University of Arizona nearly triples survival rates.

Results from a 3-year trial of the new procedure were compared with those of the previous 3-year period. During the ‘control’ period when standard CPR was used, out of 92 adult patients with cardiac arrest, 18 (20%) survived. With the new approach (called cardiocerebral resuscitation, or CCR) there were 33 such patients, of whom 19 (57%) survived.

What’s the difference in the two techniques? With CCR, the emergency personnel skip the first steps usually used – putting a tube into the trachea for an airway, and giving a shock with a defibrillator. They still connect the defibrillator, but without waiting for analysis of the heart rhythm they immediately begin fast, forceful chest compressions. Stopping chest compressions for lung ventilations was found to do more harm than good.

This approach was developed after lab studies had shown that the most important factor for survival was maintaining blood flow through the body by chest compressions. This is particularly critical when assistance arrives between 4 and 10 minutes after cardiac arrest – the most usual situation.

The researchers believe that CCR will have world-wide impact on survival rates after cardiac arrest outside hospital. Further studies will be needed, but if the method is confirmed to have the stated advantages, many more lives will be savable.