- The Washington Times - Monday, November 28, 2005

DALLAS (AP) — New guidelines advise doubling the amount of chest compressions given during cardiopulmonary resuscitation and cooling the heart attack victim afterward.

The revised guidelines on CPR issued yesterday by the American Heart Association advise giving 30 chest compressions — instead of 15 — for every two rescue breaths.

“Basically, the more times someone pushes on the chest, the better off the patient is,” said Dr. Michael Sayre, an Ohio State University emergency medicine professor who helped develop the new recommendations.

“When you stop compressions, blood flow stops,” said Mary Fran Hazinski, a clinical nurse specialist at Vanderbilt University Medical Center who also helped develop the guidelines.

The guidelines also recommend cooling cardiac-arrest patients for 12 hours to 24 hours to about 90 degrees Fahrenheit. Two significant studies have shown that practice can improve survival chances and brain function of those who are comatose after initial resuscitation.



Studies show that the chest compressions create more blood flow through the heart to the rest of the body, buying time until a defibrillator can be used or the heart can pump blood on its own.

The new guidelines also cut down on the number of times a rescuer needs to use a defibrillator, and they advise rescuers not to stop after giving two rescue breaths to check for signs of circulation before starting compressions. The bottom-line advice is to focus on the chest compressions.

Instead of applying the defibrillator pads up to three times before beginning CPR, the guidelines advise rescuers to give just one shock and then do two minutes of CPR beginning with chest compressions before trying the defibrillator again.

Studies show that the first shock works more than 85 percent of the time, and survival rates have been as high as 49 percent to 74 percent for lay rescuer programs when defibrillators are placed in casinos or airports or used by police.

More than 300,000 Americans die each year of cardiac arrest, when the heart suddenly stops beating. According to the heart association, about 75 percent to 80 percent of all cardiac arrests outside hospitals happen at home, and effective CPR can double a victim’s chance of survival.

Cardiac arrest can occur after a heart attack or as a result of electrocution or near-drowning. It’s most often caused by an abnormal heart rhythm. The person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing.

“The most common reason many people die from cardiac arrest is no one nearby knows CPR,” Dr. Sayre said.

The new guidelines provide an opportunity for those who have taken CPR lessons to take a refresher course, said Dr. Ahamed Idris, professor of surgery and medicine at the University of Texas Southwestern Medical Center.

“I think it’s a good idea for people to take CPR lessons at least every couple of years,” said Dr. Idris, who also was involved in creating the guidelines.

The heart association says about 9 million Americans are trained in CPR per year. The association wants to more than double that number in the next five years to 20 million.

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