Study: More CPR, Less Defibrillator Better

Cardiac Arrest May Be Better Helped With Additional Chest Compressions, Fewer Electric Shocks

(WebMD)  More chest compressions from CPR and fewer shocks from a defibrillator may be better at saving lives after cardiac arrest, according to a new study.

Cardiac arrest occurs when the heart is unable to effectively pump blood because of — in most cases — an irregular heart rhythm. Unless the heart rhythm is quickly restored with the use of CPR (cardiopulmonary resuscitation) and/or electric shock from a defibrillator, the victim can die within minutes.

Researchers found that new cardiac arrest treatment guidelines, which call for a single shock from a defibrillator followed by two minutes of CPR, improved survival rates after cardiac arrest compared with older guidelines that called for greater use of the defibrillator.

"The new way of thinking is that we should administer shocks only at key times in order to provide more CPR during the resuscitation," says researcher Thomas Rea, M.D., M.P.H., associate professor of medicine at Harborview Medical Center at the University of Washington in Seattle, in a news release. "The idea is that the CPR prepares the heart to better accept the shock and have the shock work."

The new guidelines, published in 2005 by the American Heart Association, place more of an emphasis on CPR, particularly chest compressions, with minimal interruptions. Previous cardiac arrest treatment guidelines called for repeated shocks and a pulse check before starting CPR.

CPR Still Saves Lives

In the study, researchers compared survival rates among people who were treated for cardiac arrest outside a hospital under the old guidelines between 2002 and 2004 to those treated under the new guidelines in 2005.

The results showed survival rates (hospital discharge) improved from 33 percent to 46 percent under the new resuscitation guidelines.

Researchers say the findings suggest that emergency medical staff should consider switching to the new guidelines for cardiac arrest treatment.

"These are not definitive results," says Rea. "But certainly our findings are encouraging and would indicate that changing to the new American Heart Association guidelines probably ought to be high priority."

The results of the study appear in Circulation: Journal of the American Heart Association.

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SOURCES: Rea, T. Circulation: Journal of the American Heart Association, Dec. 11, 2007, rapid online access edition; vol. 114. News release, American Heart Association.

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Sobering news.Defibrillaters seem to be saving so many lives, and we are finding them everywhere.I think they are an ivaluable tool in the fight against sudden cardiac arrest.We should keep pushing this device because with cpr alone many would die, but with the defibrillator lives are being saved everyday.