Until three years ago, Arizona's success rate in cases like this was no better than most of the country. This past month, however, physicians in the state reported in the Journal of the American Medical Association that a new regimen by paramedics has tripled the success rate, to more than 5 percent. Among patients whose collapse from cardiac arrest was observed, long-term survival went from 4.7 percent to 17.6 percent.
In a bold departure from standard practice, paramedics in most Arizona cities do not follow the guidance of the American Heart Association. Instead, they follow a protocol that was developed at the University of Arizona's Sarver Heart Center, largely by Dr. Gordon Ewy.
Even after cardiac arrest, Ewy said, there's enough oxygen in the body to feed the brain and keep a person alive for several minutes. But that air helps only if someone compresses the heart to circulate blood. In traditional CPR, rescuers alternate 30 chest compressions with two long "rescue breaths." Paramedics are trained to start by checking the airway, and insert a breathing tube at the start of resuscitation. These extra steps, said Ewy, waste precious time.
In Arizona, paramedics skip the breathing step. They simply alternate two minutes of pumping on the chest -- 200 compressions -- with a single shock from a defibrillator.
This is similar to a story Newsweek reported last summer, which indicated that giving oxygen to cardiac arrest patients is the wrong thing to do. It's nice to see Arizona on the cutting edge, here.