Science
10:50 am
Wed April 4, 2012

Confirmation: Pressing the chest saves lives

Focus on your hands. 

That underlying message is getting reinforcement from new research on how to save someone who has a sudden heart attack. Victims who get CPR that emphasizes chest compressions have a survival rate that's nearly double those who get older types of CPR, according to a study from King County.

The Seattle area has been a leader for decades in promoting CPR -- and in studying what works best for emergency response. The latest research looks at the silent majority of people who suffer sudden cardiac arrest. These are victims whose heart stops beating, and they drop to the floor, but they can’t be revived with electrical shocks (or defibrillation).

These “non-shockable” victims are about 75% of all cardiac arrest cases, according a new study published by the journal of the American Heart Association, Circulation. Lead author Dr. Peter Kudenchuk of the University of Washington says nobody had answered the question:

“Can CPR without the benefit of shock improve the outcome for those folks?”

Kudenchuk says it’s hard to investigate what might help these victims, because you can’t really do any experiments on someone who just dropped dead and needs emergency revival.

But Kudenchuk grabbed a unique opportunity. In 2005, the guidelines for CPR changed. Starting that year, emergency responders were told to maximize how many times they press down on the chest, and worry less about electrical shocks or rescue breathing.

So, the researchers compared survival rates before the change and afterwards, covering a ten year period and 3,960 victims. They found victims are now getting on average an extra 100 chest compressions in the first five minutes – and it is saving lives.

“This is just using your hands in a way that promotes circulation, and it works. And it can almost double survival in patients who otherwise have a very, very bad outlook from this terrible event,” said Kudenchuk.

Doubling the survival rate is impressive – and translates into saving about 2,500 lives a year nationally, if this type of CPR were universal. 

But, the overall situation is still pretty dismal, since more than 90% of cardiac arrest victims won’t make it, if they have the type that can’t be shocked. 

Preventing or predicting cardiac arrest would be much better, but that's still at the frontiers of science.