Constant chest compressions during cardiac resuscitation triples the survival rate of out-of-hospital cardiac arrest, according to a study in the March 12 Journal of the American Medical Association.
Researchers form the Mayo Clinic in Scottsdale, AZ, led by Bentley J. Bobrow, MD, conducted a prospective study in two metropolitan cities and surrounding areas in Arizona to test the efficacy of minimally interrupted cardiac resuscitation (MICR), an alternate EMS protocol. MICR includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, 200 immediate postshock chest compressions before pulse check or rhythm reanalysis, early administration of epinephrine, and delayed endotracheal intubation.
They found that survival-to-hospital discharge increased from 1.8 percent without MICR to 5.4 percent with it in a group of 886 patients who suffered cardiac arrest. They also found survival increased from 4.7 percent without MICR to 17.6 percent with it in a subgroup of 174 individuals with witnessed cardiac arrest and ventricular fibrillation.
In an analysis of MICR protocol compliance involving 2460 patients, survival-to-hospital discharge improved with MICR, from 3.8 percent to 9.1 percent among individuals with cardiac arrest and from 11.9 percent to 28.4 percent with witnessed ventricular fibrillation.
Researchers concluded that this alternate protocol is effective in improving outcomes in patients with out-of-hospital cardiac arrest, and randomized studies are needed to confirm these findings.