NYT: CPR works better than previously thought

Emphasis below is mine. Nancy Valko, RN also has a comment with the article that gives my own thinking.

God bless!

---------- Forwarded message ----------
From: Nancy Valko

Comment: Many people are encouraged to refuse CPR by way of "living wills"
and the usual stat given is that CPR fails about 70% of the time. But note
the new stats on out of hospital resuscitations: "

"The researchers defined survival as surviving at least through hospital
discharge," the heart association said. "They found that from 2002 through
2004, survival rate after cardiac arrest averaged 33 percent when patients
were resuscitated out of the hospital using 2000 guidelines.
"Survival improved to an average 46 percent for the group that received
resuscitation with the new 2005 protocol."

    Just a few weeks ago, a 50 year old friend went into cardiac arrest at a
lecture. His girlfriend, an ICU nurse, started CPR and called for a portable
defibrillator. Some doctors also stopped to help. The man was shocked 10
times and transported to a nearby hospital. He was found to have a 100%
blockage in one artery and was treated. He not only survived but had NO
heart or brain damage. A test showed that he didn't even need an internal
defibrillator.

   My point is that sometimes a Do Not Resuscitate order is appropriate but
people should consider these facts before automatically rejecting CPR.

Nancy V.

http://www.nytimes.com/2006/12/12/health/12cpr.html

New Guidelines Alter Cardiac Arrest Response

            By REUTERS
Published: December 12, 2006

DALLAS, Dec. 11 - More CPR, less shock. That was the new directive issued by
the American Heart Association on Monday for emergency workers helping
victims of cardiac arrest.

Tests show that giving a little cardiopulmonary resuscitation before
repeatedly using a defibrillator can help more patients survive a crisis in
which their heart stops pumping blood effectively.

CPR, which involves manual compressions of the chest, is the standard first
aid response to someone suffering cardiac arrest.
Previous guidelines stressed the use of a defibrillator, normally
administered by emergency medical personnel after their arrival at the
scene.

However, defibrillators meant for use by laypeople are also being installed
in airports, gyms and other public areas.

"The new way of thinking is that we should administer shocks only at key
times in order to provide more CPR during the resuscitation," said Dr.
Thomas Rea, who led a study that was published in the journal Circulation
and was used as the basis for the new guidelines.

"The idea is that the CPR prepares the heart to better accept the shock and
have the shock work," Dr. Rea, an associate professor of medicine at
Harborview Medical Center at the University of Washington in Seattle, said
in a statement.

The old guidelines called for repeated shocks and a pulse check before
administering CPR.

The new method employs a single shock followed by two minutes of CPR, the
heart association said.

For most laypeople who have no access to a defibrillator, the standard
response remains the same.

"In most circumstances, the layperson can recognize that there is an
emergency, call 911 and administer CPR while they wait for the emergency
responders," Dr. Rea said.

The new approach was tested in King County, Wash., by emergency medical
technicians, who started using the procedure on Jan. 1, 2005.

"The researchers defined survival as surviving at least through hospital
discharge," the heart association said. "They found that from 2002 through
2004, survival rate after cardiac arrest averaged 33 percent when patients
were resuscitated out of the hospital using 2000 guidelines.

"Survival improved to an average 46 percent for the group that received
resuscitation with the new 2005 protocol."