Cardiopulmonary resuscitation is crucial when people collapse with cardiac arrest, but it's hard to perform correctly. Now major efforts are under way to improve how doctors, paramedics and average bystanders do the job: New CPR guidelines are due this fall, and high-tech machines that promise to help are already showing up in ambulances and offices.
Not yet proven is whether using technology — like a chest-squeezing gadget or sensors that coax rescuers to pound harder — to spice up the 40-year-old resuscitation technique really will save lives.
Emergency-care specialists agree that CPR today doesn't save as many lives as it could.
"We've got our work cut out for us to make sure CPR is done better," says Mary Fran Hazinski of the American Heart Association, which is finalizing new recommendations designed to do just that.
More than 300,000 Americans each year die of cardiac arrest, where the heart's electrical system goes haywire and the heart abruptly stops beating.
Portable defibrillators can increase survival, delivering a jolt of electricity that stuns the heart, ending the abnormal rhythm and giving it a chance to resume a normal beat.
But the heart-zappers alone aren't enough. Virtually all cardiac-arrest victims need CPR, too. It buys time until a defibrillator arrives. Often, it's needed immediately after zapping, as the heart struggles to resume circulation.
Also, studies show that doing CPR first makes defibrillation more likely to work if cardiac arrest has lasted longer than three minutes. The longer someone goes without oxygen, the more their abnormal heart rhythm degrades until it's unshockable.
But "it has to be good CPR. We don't want to delay defibrillation for crummy CPR," warns Dr. Lance Becker of the University of Chicago, co-author of one of a pair of surprising studies earlier this year that found even the best-trained rescuers — doctors, nurses and paramedics — too frequently give inadequate CPR.