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Fri, Jan. 24

Call 911 first, as CPR success rates are low

Matt Hinshaw/The Daily Courier<br>Mario Gomez practices CPR on a mannequin Wednesday morning during New Life’s CPR class in Prescott.

Matt Hinshaw/The Daily Courier<br>Mario Gomez practices CPR on a mannequin Wednesday morning during New Life’s CPR class in Prescott.

PRESCOTT, Arizona - Cardiopulmonary resuscitation, or CPR, has been around since about 1960.

It is as familiar to the public as the police Miranda warning ("You have the right to remain silent..."), and for the same reason: TV shows, from the early '70s "Emergency!" to more current medical dramas, have featured medics pumping away at CPR as the sure-fire way to save a patient's life in the case of cardiac arrest.

But reality can be different.

Studies re-leased recently suggest a survival rate of between two and 16 percent for people who received what's called "bystander CPR" - out-of-hospital treatment. For example, a 2012 Japanese study of 400,000 people found that, even with professional CPR and the drug epinephrine, 18 percent were brought back to spontaneous circulation, but fewer than 5 percent lived a month afterwards and fewer than 2 percent made it past one month with normal brain function.

Martin De Kort, M.D., an emergency room physician at Yavapai Regional Medical Center, said, "The numbers aren't good. Any time your heart has stopped, we can get only 10 percent back, even on a good day.

"The key there is it has to be effective CPR," he said, noting that even people trained in the technique may not do it effectively.

De Kort suggests that, though the survival numbers are low, they are still worthwhile.

"Four-to-five percent survive (with CPR) versus about 1 percent (without it), and intact neurologically, we're probably talking 3 percent out of the hospital with effective CPR versus less than 1 percent," he said.

"Unfortunately, people get caught up in those numbers, and the reality is, doing something is a chance for survivability," said Glenn Kasprzyk, Chief Operating Officer of Life Line Ambulance.

Kasprzyk pointed out, though, that, "if somebody's climbing up Granite Mountain, and they have a heart attack and the next person who finds them is 15 minutes behind them, statistically, are they going to have a good chance of survival? No."

But, he said, the reality is that, even with "hands-only CPR," a new method, a victim "is going to have a much higher chance of survivability" than he would if bystanders did nothing.

Lesa West and her husband Dan operate New Life, a CPR and first aid training company in Prescott. Lesa said many people don't understand the real point of CPR. "CPR is what keeps the body alive until 911 shows up with a defibrillator," she said.

The TV shows that depict a cardiac patient "coming back" during CPR "are just television," she added. "Only a defibrillator is going to get the heart pumping" on its own, which is why automated external defibrillators, typically located in public buildings, are important.

New Life classes teach students to do CPR with chest compressions and rescue breathing. The American Heart Association and the Red Cross are advocating the hands-only method, but, Lesa said, she can't teach it until the International Liaison Committee on Resuscitation certifies the technique.

Ultimately, the question becomes whether a bystander should do CPR, even given a small chance of success, versus doing nothing.

Kasprzyk said he would rather do something potentially useful - "it can't hurt," he said - in the case of sudden cardiac arrest, even if it's not as effective as the public may believe it to be.

"When you do CPR, (patients) have no pulse. You can't make them deader," Lesa pointed out. "You can only help them."

Or, as De Kort said, "If my heart stops, and I have a 3 percent chance of returning to normal function, I'll take that."

Follow the reporter on Twitter @AZNewsguy

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