The compressions need to be applied in the center of the chest at a rate of about 100 a minute -- ironically, about the same rhythm as the Bee Gees' song "Stayin' Alive." One study has found that performing chest compressions while listening to that song improved the CPR technique of physicians and medical students.
"Laypersons with no formal training in CPR, when they're presented with someone in cardiac arrest, can do a pretty decent job with chest compressions," Garza said.
Garza and Eckstein go further than the American Red Cross or the American Heart Association, however, saying that even trained rescuers should focus on uninterrupted chest compressions rather than trying to juggle compressions with mouth-to-mouth or other treatments.
It takes many repeated chest compressions to increase pressure enough to begin driving blood into heart tissue, Garza said. "By the time you got to your 15th chest compression, you'd just gotten to where you were doing some good, and then you'd stop to perform mouth-to-mouth, and it went back to zero," he said.
Both doctors have studied what happens when paramedics change their cardiac protocols to focus more on chest compressions, Garza in Kansas City and Eckstein in Los Angeles. They both found that survival rates improved when paramedics delayed intubating patients, administering medications or performing defibrillation in favor of consistent compressions.
Chest compression CPR is more valuable than defibrillation because rescuers often arrive too late for effective defibrillation, which needs to occur within five minutes of cardiac arrest, Garza said.
"The problem is, most paramedics don't arrive in the first five minutes," he said. By the time rescuers arrive, the body's tissues are starved for oxygen and the heart cells are depleted of energy.
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