More CPR, less shock for cardiac arrest-AHA

DALLAS, Dec 12 (Reuters) More CPR, less shock: that is 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 using a defibrillator can help more heart patients survive a crisis in which their heart stops pumping blood effectively.

CPR involves manual compressions of the chest. It is the standard first aid response to someone suffering cardiac arrest, in which the heart stops contracting, sometimes fluttering, or fibrillating, instead.

Previous guidelines have also stressed the need to give urgent shocks from a device called a defibrillator, which would normally be administered by emergency medical personal 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 used as the basis for the guidelines.

''The idea is that the CPR prepares the heart to better accept the shock and have the shock work,'' 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 along with a pulse check before administering CPR. The new way endorses 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 lay person can recognize that there is an emergency, call 911, and administer CPR while they wait for the emergency responders,'' Rea said in a telephone interview.

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

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

''Survival improved to an average 46 percent for the group that received resuscitation with the new 2005 protocol,'' it added -- a substantial improvement that saved lives.

The results of the study are published in the journal Circulation.

REUTERS SSC MIR RAI1039