TUCSON, Ariz. -- Soaring survival rates for Arizona cardiac-arrest victims given the "new CPR" are receiving national attention, boosting the push to adopt the technique worldwide. But rescuers in Seattle, ahead of the curve, have been using the new method for years.
Pioneered by heart researchers at the University of Arizona, the new technique stresses hard and fast chest compressions instead of mouth-to-mouth breathing or mechanical ventilation, when performed by paramedics or untrained bystanders.
"Chest compressions are where it's at," said Lt. Jonathan Larsen, EMS Training Coordinator for the Seattle Fire Department, who has been using the continuous compression method -- with some ventilation -- since 2005.
"We believe that as a result our resuscitation rates improved by about 40 percent," he said, adding that King County adopted a similar protocol during the same year and has seen comparable results.
Known as "cardiocerebral resuscitation," or CCR -- that method has tripled survival rates and dramatically decreased brain damage in Arizona adults rescued by paramedics after suffering sudden cardiac arrest.
Those results were published this month in one of the nation's most prestigious medical journals, the Journal of the American Medical Association. That has triggered coverage of the method in national media outlets, including CNN News and major newsmagazines.
"This is getting worldwide attention now, and with every study, it is looking more and more like this method does improve survival of one of our main killers," said Dr. Bentley J. Bobrow, an emergency physician who is chief of emergency medical services at the Arizona Department of Health Services, and a co-author of the report.
"We strongly believe that every fire department in the state and in the U.S. should check their survival rates for cardiac arrest, and if they are not good, they should consider switching to this technique," Bobrow said. "Arizona has shown that (these) simple changes to the (CPR) protocol will dramatically improve meaningful survival."
Sudden cardiac arrests that occur out of hospitals kill more than 450,000 Americans every year -- second only to all cancers combined.
Survival rates from performing traditional CPR -- combining chest compressions with mouth-to-mouth breathing or mechanical ventilation -- have remained dismal for decades, at 5 percent or lower, whether performed by trained paramedics or untrained bystanders.
The new report compared cardiac-arrest survival rates achieved by paramedics in the two largest Phoenix-area fire departments before and after they were trained in CCR.
Paramedics using the old CPR -- which calls for mechanical ventilation and electric shock before doing chest compressions -- were able to save only 1.8 percent of cardiac-arrest victims.
But after training in the new CCR technique -- which requires 200 chest compressions first, then a single shock followed by 200 more chest compressions, with delayed ventilation -- the survival rates jumped threefold, to 5.4 percent.
The figure measures survival of the patient to actual discharge from the hospital, not just getting to the hospital.
"While this is interesting from a nationwide perspective," Larsen said, "it just kind of validates the direction we've been taking in Seattle for quite a number of years."
Also, in those cardiac-arrest victims with the best chance to live -- who were seen collapsing and who still had some heart rhythm -- survival jumped from 4.7 percent with the old CPR to 17.6 percent with the new CCR.
"The major thing, the key to improved survival with minimal brain damage, is the perfusion effect -- getting blood flow back to the heart and brain. That's what chest compressions do," said Dr. Gordon Ewy, director of the University of Arizona Sarver Heart Center and co-author of the new report.
"Any interruption of that -- what happens when you stop to do breathing or ventilation -- stops that blood flow, and that risks brain damage or death."
It was Ewy's Resuscitation Research Group at the Sarver Center that developed the new CCR method and first presented it in Tucson in 2003.
"I can tell you that once they try it, the most enthusiastic are the paramedics themselves," Ewy said. "They know better than anyone else how miserable the survival rates were before they learned this."
Twelve fire departments out of 62 in Arizona -- including the Tucson Fire Department -- have adopted the CCR method. However, the Tucson department declined to take part in this study and has not released survival data. CCR also has been adopted by fire departments in Wisconsin, Kansas, Missouri and Illinois, Ewy said.
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