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Cardiocerebral Resuscitation, A New Technique For Out-Of-Hospital Cardiac Arrest

t in most large cities in the United States. Survival rates are better only if an automated external defibrillator (AED) is available and is used soon after the cardiac arrest.

'We think CPR is not optimal because it is advocated as a 'one-size-fits-all' approach, ignoring that cardiac arrest and respiratory arrest are two distinct pathophysiological conditions,' says Ewy. 'Ventilations are necessary in cases of respiratory arrest, such as near-drowning accidents or drug overdose.'

Studies have shown that bystanders performing CPR take much longer to deliver rescue breaths in between chest compressions than previously thought – an average of 16 instead of the presumed 4 seconds. Research by the UA Sarver Heart Center CPR Research Group revealed that even highly enthusiastic medical students in excellent shape need 14 seconds to deliver the ventilations.

'As a result, people interrupt the chest compressions for prolonged periods of time,' says Ewy. 'This does not provide optimal perfusion of the vital organs.'

The new data confirm a study published earlier this year (The American Journal of Medicine (2006) 119, 335-340). Emergency medical services in two Wisconsin counties were able to increase survival rates three-fold when they switched from guideline CPR to Cardiocerebral Resuscitation. 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 rhythm. 'Shockable' describes a condition in which the heart quivers rather than beats but can be shocked back into normal beat with a defibrillator. In contrast, the survival rate was only 15 percent in the three years before, when the standard CPR protocol was used.

Because it does not involve mouth-to-mouth breathing, Cardiocerebral Resuscitation enhances the willingness in lay individuals to engage in an attempt to resuscitate a cardiac a
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