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Study: Paramedics save more lives when they don't follow the rules

Survival rates following the most common form of cardiac arrest increased three-fold when emergency medical personnel used a new form of CPR developed at The University of Arizona Sarver Heart Center. The new approach, called Cardiocerebral Resuscitation, is dramatically different from guideline-directed CPR procedures.

Because of its importance, the editors of the American Journal of Medicine chose to publish the report online in advance of the journal's April print issue.

"Cardiocerebral Resuscitation eliminates certain previously recommended procedures and reprioritizes the order of actions the emergency medical services deliver," said Michael J. Kellum, MD, leading author of the study report.

Under the new approach, first responders skipped the first steps of the standard protocol: intubating the patient for ventilation and delivering a shock using a defibrillator. While still attaching the victim to a defibrillator, they did not wait for the device to analyze the patient's heart rhythm, but started fast, forceful chest compressions.

"Intubating the patient and waiting for the defibrillator to do its analysis takes time ?time a cardiac arrest victim doesn't have," said Gordon A. Ewy, MD, director of the Sarver Heart Center and co-author of the study. "I am convinced that Cardiocerebral Resuscitation will have a world-wide impact."

"In laboratory experiments, we found that the most important factor of survival is to keep the blood moving through the body by continuous chest compressions," said Dr. Ewy, who pioneered the CPR Research Group at the Sarver Heart Center. "Stopping chest compressions for ventilations was far more harmful than helpful. Excessive ventilations during chest compression turned out to be harmful, too."

First responders applying the new protocol were able to resuscitate the majority (58 percent) of out-of-hospital witnessed cardiac arrest victims, provided they had a "shockable" initial heart r
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Source:University of Arizona


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