CPR study shows lives saved

A change in the way first responders deal with administering CPR to cardiac arrest patients has proven to save lives, according to a local study.

The study, done by the University of Missouri-Kansas City and Truman Medical Center and published in Circulation magazine, changed the ratio of chest compressions to breaths given to someone suffering cardiac arrest. The ratio in the study of 50 chest compressions to every two breaths more than doubled the patient’s chance of survival.

“You stop the blood pressure forward flow when you stop, so when you restart compressions it takes many seconds of compressions to get back to the level of when you stopped,” Matthew Gratton, UMKC professor and former director of the Kansas City Emergency Medical System, said. “If you stop compressions for five seconds, it’s really like stopping for 15 or 20.”

Gratton said the impetus for the study came from research done at Sarver Heart Center in Arizona, where researchers found much higher survival rates for cardiac arrest patients by giving only chest compressions and no breaths.

“From the mid-’90s we had been tracking the cardiac arrest survival rate,” Gratton said. “The survival rate had stayed fairly flat over the years. We wanted to do whatever we could do to improve the survival rate.”

Gratton authored the study with Alex Garza and Joseph Salomone, who both were heads of the Kansas City EMS at different times this decade. Other authors of the study include Daniel Lindholm, James McElroy and Rex Archer.

The study specifically looked at patients who suffered ventricular fibrillation, which Gratton describes as the type of arrest where the heart can be shocked back into running properly. In those cases, the survival rate of patients moved from 22.4 percent to 43.9 percent.

In overall sudden cardiac arrest survival, the survival rate moved from 7.5 percent to 13.9 percent.

Key players in the study were MAST paramedics and Kansas City fire fighters, who administered CPR to the patients. Acting MAST CEO Gil Glass said first responders found great hope in learning the new techniques equaled more lives saved.

“The crews have seen the benefit in the change in protocol,” Glass said. “We’re getting better patient outcomes.”

The study, which looked at patients from April 2006 to May 2007, already has led to changes among local first responders.

“In July of 2008, the system did go to 200 (breaths) to 0,” Gratton said. “The American Heart Association currently recommends a 30-2 ratio. Our study was a 50-2 ratio. … Today in Kansas City, if you keel over, the EMS system is going to give 200 compressions.”

Gratton said similar steps have been taken in other metro areas around the country as more statistics are discovered about the benefit of more chest compressions for cardiac arrest patients.

Gratton warns that the results are strictly for cardiac arrest patients – not all patients who receive CPR.

“Studies like ours are specific to cardiac arrest,” Gratton said. “If you drown in a swimming pool, that’s repertory arrest. In that case you probably should be getting ventilation. Children were also not the primary focus of our study … most kids don’t have cardiac arrest. That usually happens in those 30 and above. So for kids we recommend to not do this.”

Gratton said all first responders, nurses and doctors hope to see more cardiac arrest patients walking out of the hospital alive.

“We were all frustrated by the cardiac arrest survival rate not improving for a decade,” Gratton said. “During that time we were doing a lot without standard of care and we hoped for a change in the results. With the change in protocol and research, we were confident something was going to get better. We are all extremely happy that appeared in our work.”

Trackback(0)

TrackBack URI for this entry

Comments (0)

Write comment