# New CPR Technique



## oneluv79 (Mar 14, 2008)

*New CPR Technique Triples Survival Rates
*
Posted on: Wednesday, 12 March 2008, 06:10 CDT

Researchers in Arizona reported that three times as many people survived a cardiac arrest when a new method of resuscitation, which involves a series of 200 chest compressions followed by defibrillator shock, was implemented.   

"Cardiac arrest is incredibly common and survival is poor," said Dr. Bentley Bobrow, medical director for emergency services for the state of Arizona and a researcher at the Mayo Clinic in Scottsdale.   

The new resuscitation method, which is not intended for bystanders, increases blood flow to the heart and brain after cardiac arrest stops the heart from pumping blood.

"Even if you could improve survival by a few percentage points, you will save thousands of people across the country," said Bobrow, the study’s lead author.

Experts say the most helpful thing bystanders can do for someone suffering a cardiac arrest is to give chest compressions while awaiting an ambulance.

Cardiac arrest occurs when the heart stops circulating blood.  People with cardiac arrest typically have ventricular fibrillation, a deadly heart rhythm in which the heart quivers but does not pump blood
. It is during this phase that old-fashioned chest compressions can help push blood back into the heart, making it more likely to restart.  If shock is not delivered within the first four minutes, the heart may stop altogether and resuscitation becomes much more difficult.

Since most emergency teams do not arrive on scene within four minutes, the new resuscitation approach calls for a round of 200 chest compressions within the first two minutes to increase the odds the heart will restart.

"Traditionally, we've told them to defibrillate right away. When they do that, the patient dies frequently," Bobrow said in a Reuters telephone interview.

Only 3 percent of people in Arizona who had a cardiac arrest outside of a hospital survived in 2004. Bobrow wanted to improve the statistics. He and his team studied the use of minimally interrupted cardiac resuscitation, also known as cardio cerebral resuscitation, a highly sequenced form of CPR performed by emergency medical workers.

After the first 200 compressions, the patient gets a shock, then a different worker provides another 200 chest compressions. At that point, shots of epinephrine may be given to stimulate the heart, followed by a tube insertion into the trachea to ventilate the lungs.

The method aims to continuously pumping blood to the heart and brain.

During the study, Bobrow's team trained emergency workers in two Arizona city fire departments, then compared the survival data from 2005 to 2007 for 886 cardiac victims before and after the procedure was implemented.

The analysis showed the rate of people who lived long enough to be discharged from the hospital was 1.8 percent before the training and 5.4 percent after the new procedure began being used.  The benefit was greatest for those who had ventricular fibrillation with a shockable rhythm, with survival rates jumping from 4.7 percent to 17.6 percent among the group.

In a commentary to the study’s report, Dr. Mary Ann Peberdy of Virginia Commonwealth University in Richmond said the findings suggest the need for a back-to-basics approach to cardiopulmonary resuscitation.

"We are learning more and more that we can't get sloppy on how we do CPR," she wrote.


http://www.redorbit.com/news/health/1293214/new_cpr_technique_triples_survival_rates/[/url]



*My questions are:

1.  Is this CPR technique being applied in any other places besides where the research took place (by any EMS services)? 
2.  And do will you think it will be added to the CPR certifications or Re-certification tests in 2008?*


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## ffemt8978 (Mar 14, 2008)

I tried the link that you provided, but it comes back story not found.


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## Ridryder911 (Mar 14, 2008)

EMSA out of Tulsa and OKC now informs the public to perform 200 compressions without ventilation before EMS arrives. I have not heard of any major changes of cardiac arrest saves. since they have started this. 

The do use the rescue pod and describes significant difference with that. 

R/r 911


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## Ops Paramedic (Mar 14, 2008)

I have also only heard of this 200 compression then shock technique this morning.  We are currntly practicing resuscitation as per the guidelines of the Resuscitation Council of South Africa.  These guidelines are in line with the other councils from around the world, i.e. europe, australia and america.  It has changed in the past year or two, with the focus being more on the chest compressions and BLS, rather than the drugs and intubation.  It sounds like we are leading toward what the article is describing, but maybe not in such detail, as for e.g. the 200 compressions, defib once, and then another 200 compressions.

Some people in the indrustry frown upon those who step outside the norm, or from what is published.  I think that should you have enough knowledge do to something like this (which is not far off), you can try it.  Lets keep an eye out and see what happens.


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## triemal04 (Mar 14, 2008)

Cardio-cerebral rescucitation.
http://www.ncbi.nlm.nih.gov/sites/en...1000m,isrctn
http://web.kshb.com/kshb/pdf/ACurren...Ewy06MCC58.pdf
http://circ.ahajournals.org/cgi/cont...ll/111/16/2134

Interesting reading.  More info was in this thread awhile back.
http://www.emtlife.com/showthread.php?t=5470


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## skyemt (Mar 14, 2008)

researchers were finding that the public, when faced with providing respirations, were not doing CPR at all...

this change is in part designed to get the public to do compressions, which are arguably more important than respirations, by taking away the factor that was inhibiting them.

NYS, citing research, is changing it's CPR protocols to incorporate ITD's (impedance threshold devices), stating that survival to discharge is greatly improved by providing respirations with this device.


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## paramedix (Mar 18, 2008)

Ops Paramedic said:


> I have also only heard of this 200 compression then shock technique this morning.  We are currntly practicing resuscitation as per the guidelines of the Resuscitation Council of South Africa.  These guidelines are in line with the other councils from around the world, i.e. europe, australia and america.  It has changed in the past year or two, with the focus being more on the chest compressions and BLS, rather than the drugs and intubation.  It sounds like we are leading toward what the article is describing, but maybe not in such detail, as for e.g. the 200 compressions, defib once, and then another 200 compressions.
> 
> Some people in the indrustry frown upon those who step outside the norm, or from what is published.  I think that should you have enough knowledge do to something like this (which is not far off), you can try it.  Lets keep an eye out and see what happens.



I have also heard about this from Ops Paramedic and we were discussing this on our way to a CPR IN PROGRESS call-out. As mentioned we work strictly withing our given guidelines set out by the resuscitation council. Would love to try this and provide feedback if this study is implemented here.


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## james (Mar 18, 2008)

this is the link to the site i am reading right now it is a good read

http://www.redorbit.com/news/health/1293214/new_cpr_technique_triples_survival_rates/index.html


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