Thursday, April 05, 2012 Evidence Supports Using More Chest Compressions for Nonshockable Cardiac Arrest People who have a cardiac arrest that can't be helped by a defibrillator shock are more likely to survive if given cardiopulmonary resuscitation (CPR) based on updated guidelines that emphasize chest compressions, according to the American Heart Association (AHA). AHA changed its CPR guidelines in 2005 to recommend more chest compressions with fewer interruptions. The emphasis on chest compressions continued in the 2010 guidelines update. After the 2005 guidelines, several studies showed improved survival from shockable cardiac arrest. However, new evidence shows that most cardiac arrests—nearly 75%— are due to conditions that don't respond to shocks. Researchers identified 3,960 patients in King County, Washington, who had a type of cardiac arrest that doesn't respond to shock from a defibrillator, or nonshockable cardiac arrest. They compared survival rates among patients who had nonshockable cardiac arrests from 2000-2004—before the 2005 guidelines changes—to those who had nonshockable arrests from 2005-2010 and found: The likelihood of survival to discharge from the hospital improved from 4.6% before to 6.8% after the new guideline changes. The proportion of patients who survived with good brain function increased from 3.4% to 5.1% between study periods. One-year survival almost doubled from 2.7% to 4.9%. Free full text of the study is available online in Circulation.