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Too Many Interruptions Found in CPR

cpr-study

DALLAS, Texas - Quick, consistent and uninterrupted chest compressions; researchers in Dallas say focusing on chest compressions during Cardiopulmonary Resuscitation (CPR) is key to a patient's survival.

"We learned there were too many interruptions in chest compressions during CPR," explains Ahamed Idris, M.D., Professor of Surgery and Emergency Medicine at UT Southwestern Medical Center in Dallas.

"By doing vigorous chest compressions, without interruption, a person can actually produce reasonable circulation to help that person stay alive until a professional arrives," says Idris.

In the past CPR instruction focused on a sequence of 30 chest compressions, followed by two breaths, then another 30 compressions and two breaths.

Researchers say 40 lives were saved in 2009 in the 12 cities participating in the Resuscitation Outcomes Consortium (ROC) study. It was funded by the National Institutes of Health, and researchers say it reveals positive outcomes for patients when paramedics focused on chest compressions after a person collapsed due to heart ailments.

"Paramedics tended to move the person from the home to the ambulance and begin transport to the hospital too soon," explained Idris.

Now the focus is on performing CPR within one to five minutes and not moving the patient. Idris says in the past paramedics interrupted chest compressions by moving the patient, inserting breathing tubes, applying AED shocks, checking heart rhythm and starting an I.V.

Researchers say the $3.5 million NIH grant paid for equipment, doctors, staffing, equipment, monitoring of 10,000 patients and training for 2,000 paramedics. They say every paramedic, in the 12 cities that participated, was trained three times.

Researchers are publishing their findings and informing the general public. <a href="https://roc.uwctc.org/tiki/tiki-index.php">Click here to read the full report</a>.

It's estimated that 80-percent of CPR is performed in someone's home. "It really is up to all of us to learn CPR and do it better," says Dr. Paul Pepe, Chairman of Emergency Medicine at UT Southwestern Medical Center Dallas/Parkland Memorial Hospital.

Doctors Pepe and Idris led the study which concluded in December, but equipment used to monitor chest compressions is still being used in every ambulance in 12 Dallas-area cities. Those cities are Dallas, Carrollton, Irving, Mesquite, Farmers Branch, University Park, Highland Park, Lancaster, Desoto, Duncanville, Garland and Plano.

The technical equipment used in every ambulance continues to show researchers when each chest compression is administered. "It actually helps us monitor every single stroke of CPR," explained Pepe. "We know when it's being interrupted, how well it was done, how hard it was pushed, how fast it was pushed and we can give feedback to rescuers to help improve their style, their ability to do it and most importantly improve life-saving affects."

The consortium was recently awarded funds for a follow-up study that will include Fort Worth and 11 other cities in Tarrant County.

Idris says the research applies to people who are suspected of collapsing due to a heart ailment. But when a person has been pulled out of the water, and is a possible drowning victim, rescuers are still advised to use ventilation along with chest compressions.

The next study will reportedly examine whether there are benefits to administering mouth-to-mouth resuscitation (or bag ventilation by paramedics) simultaneously with chest compressions.



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