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CPR by Bystanders Saves Cardiac Arrest Victims , Study Finds

The rate of people surviving without brain damage after suffering cardiac arrest increased as more bystanders were willing to help until EMS arrives.

People can save lives when cardiac arrest strikes, just by getting down on their knees and trying CPR or by using a defibrillator, two new studies show.

The studies found that a few more bystanders are stepping up to help people who have collapsed, and when they do, it helps survival.

Dr. Carolina Malta Hansen of the Duke Clinical Research Institute and colleagues looked at statistics on sudden cardiac arrest. In North Carolina in 2010, just 14 percent of people who collapsed with cardiac arrest got CPR until a professional could arrive and use a defibrillator. This rose to 23 percent by 2013, after a statewide campaign to encourage the use of CPR.

But many more people at least tried. More than 86 percent of patients who collapsed got some kind of CPR before emergency medical services could get to the scene — 45 percent by bystanders and 40 percent by some other kind of first responder, such as a police officer.

Survival rose, also. In 2010, just 7 percent of people lived without brain damage but by 2013 nearly 10 percent did, they report in the Journal of the American Medical Association.

The best results came if someone started CPR and if EMS arrived quickly and used a defibrillator, the researchers found.

"During the past decade, much focus has been drawn to increasing bystander CPR," they wrote.

"Our findings suggest the possibility of improving outcomes by strengthening first-responder programs, in addition to increasing the number of bystanders who could then provide CPR, including those assisted by emergency dispatchers, and by improving EMS systems."

In a second study, in Japan, Dr. Shinji Nakahara and colleagues at Kanagawa University of Human Services found that over seven years, between 2005 and 2012, the number of times people stepped in to help rose from 14 per 100,000 cases to nearly 19 per 100,000.

And this helped survival — the number of people who lived without brain damage rose from 3.3 percent of cases to 8.2 percent.

Last month, the Institute of Medicine said experts found that a person’s odds of dying from cardiac arrest ranged from 60 percent in cities like Seattle, where many people choose to learn cardiopulmonary resuscitation or CPR, to less than 10 percent in other places.

Sudden cardiac arrest, which can be caused by a heart attack, a sudden change in heart rate or other factors, strikes as many as 400,000 Americans a year, and almost all of them die. Fewer than 6 percent of people suffering cardiac arrest outside a hospital survive, and just 24 percent of those who have one in a hospital survive.

But the American Heart Association changed its guidelines in 2008 and said no mouth-to-mouth recuse breathing is necessary — just fast, hard chest compressions to keep the heart moving blood to the brain. That change, along with more CPR education, can make people less reluctant to try to help someone who’s collapsed.