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Quicker Time to CPR Improves Survival

New resuscitation protocol recommends longer CPR initiated immediately after defibrillation

MONDAY, Dec. 11 (HealthDay News) -- A new protocol in which cardiopulmonary resuscitation (CPR) is given immediately after defibrillation and for a longer period of time significantly improves survival of cardiac arrest patients compared with multiple shocks, pulse checks and shorter CPR, according to a report published online Dec. 11 in Circulation: Journal of the American Heart Association.

The protocol is in line with the 2005 American Heart Association guidelines, which placed more emphasis on CPR. A year before the guidelines were introduced, Thomas D. Rea, M.D., M.P.H., of the University of Washington in Seattle, and colleagues implemented a new protocol calling for a single shock from a defibrillator immediately followed by two minutes of CPR. The old protocol called for multiple shocks and pulse checks before starting CPR and continuing for one minute.

The new protocol was tested for one year on 134 individuals who had a bystander-witnessed out-of-hospital ventricular fibrillation arrest because of heart disease. The results were compared with results from 374 individuals from the previous three years.

The new protocol significantly improved survival to hospital discharge (46 percent versus 33 percent), which correlated with the fact that chest compressions were started significantly sooner after defibrillation (7 seconds versus 28 seconds).

"These results suggest the new resuscitation guidelines will alter the interface between defibrillation and cardiopulmonary resuscitation and may in turn improve outcomes," Rea and colleagues conclude.

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