CPR guidelines disappoint UA doc

The change puts "the simplest step first" for traditional CPR, said Dr. Michael Sayre, co-author of the guidelines, issued by the American Heart Association.

Under the revised guidelines, rescuers using traditional CPR, or cardiopulmonary resuscitation, should start chest compressions immediately - 30 chest presses, then two breaths. The change applies to adults and children, but not newborns.

One CPR researcher, though, expressed disappointment with the new recommendations.

Dr. Gordon Ewy, director of the University of Arizona Sarver Heart Center, thinks everyone should be doing hands-only CPR for sudden cardiac arrest and skipping mouth-to-mouth. He said the guidelines could note the cases where breaths should still be given, such as near-drownings and drug overdoses, when breathing problems likely led to the cardiac arrest.

Ewy is a longtime proponent of hands-only CPR, and one of the authors of a recently published study that showed more people survived cardiac arrest when a bystander gave them hands-only CPR, compared with CPR with breaths.

On Oct. 6 in the Journal of the American Medical Association, five years of Arizona data was published showing chest-compression-only CPR is more effective than mouth-to-mouth when it comes to patients who suffer sudden cardiac arrest outside a hospital.

The survival rate for such patients is less than 10 percent. But the data provide hope that chest-compression CPR could improve those rates if more people learned the method, said Ewy, senior author of the study. Ewy helped develop chest-compression CPR at the Sarver Heart Center.

The new Heart Association guidelines say that rescuers should be pushing deeper, at least 2 inches in adults. Rescuers should pump the chest of the victim at a rate of at least 100 compressions a minute - some say a good guide is the beat of the old disco song "Stayin' Alive."

Dr. Ahamed Idris, of the University of Texas Southwestern in Dallas, said people are sometimes afraid that they'll hurt the patient. Others have a hard time judging how hard they are pressing, he said.

"We want to make sure people understand they're not going to hurt the person they're doing CPR on by pressing as hard as they can," he said.

Idris, who directs the Dallas-Fort Worth Center for Resuscitation Research, said that for the last two years, they've been advising local paramedics to start with chest compressions and keep them up with minimal interruptions. That, along with intensive training, has helped improve survival rates, he said.

He said they found paramedics hadn't been starting compressions until the patient was in the ambulance and lost time getting airway equipment together.

"The best chance was to start chest compressions in the house, immediately," he said.

Arizona Daily Star reporter Carmen Duarte contributed to this story