That interval means everything, because "we lose roughly 10 percent of the odds of the resuscitation every minute," Ornato said.
In Richmond, "90 percent of the time, we respond within eight minutes or less," he said.
And so, Ornato said, "I am less than convinced that this completely answers the question, because I don't know what it means when your drugs don't start until 20 minutes after the heart has stopped."
The trial "raises as many questions as it answers," said Dr. Nisha Chandra-Strobos, chief of cardiology at the Bayview division of Johns Hopkins University.
The slow response time is one major reason, she said: "A time to injection of 21 minutes, the game is really over at that time."
The heart association guidelines which Ornato helped prepare apply only to the medical personnel called for emergency treatment of cardiac arrest. The heart association advises persons without medical training to call for that help as quickly as possible by dialing 911.
Emergency measures can be taken before medical help arrives. Newly updated advice by the heart association says that simply depressing the chest periodically and continually can contribute to survival. If the cardiac arrest occurs in a public place such as an airport, a portable defibrillator may be available. It should be placed against the chest to deliver an electric shock that might start the heart beating again.
The symptoms of cardiac arrest and what to do about them are described by the American Heart Association.
SOURCES: Joseph P. Ornato, M.D., chairman, emergency medicine, Virginia Commonwealth University, Richmond, Va.; Nisha Chandra-Strobos, M.D., chief, cardiology, Johns Hopkins Bayview, Baltimore; Jul
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