A new technique developed at the University of Arizona School of Medicine to
revive victims of cardiac arrest without mouth-to-mouth resuscitation is
sweeping the world and saving lives. But although Magen David Adom has begun to
teach its medics how to use the Chest- Compression-Only Resuscitation (CCOR)
technique – which can be performed after watching a short video – senior Health
Ministry officials were unaware of it, and the public has not been
Unlike regular cardio-pulmonary resuscitation, in which the
rescuer alternates between 30 chest compressions and two breaths by
mouth-to-mouth resuscitation – which has been taught in first-aid courses for
decades – CCOR requires passersby only to press the center of the chest with
their two hands held one atop the other, fingers meshed and their elbows locked
into a straight position.
The University of Arizona method, whose
English-language video can be viewed at http://heart.arizona.edu/cprvideo, has
three steps: Check; Call; Compress.
Check for responsiveness by rubbing
your knuckles over the breastbone. Shake the person and shout, “Are you Okay?”
Then call; direct someone to call Magen David Adom at 101 or make the call
yourself if the person is unresponsive and struggling to breathe (gasping or
Compress – Position the victim with his back down on the floor.
Check if person is responsive by rubbing your knuckles on the breastbone. If he
is not, place the heel of one hand on top of the other and the heel of the
bottom hand on the center of the victim’s chest, between the
Lock your elbows and compress the chest forcefully; make sure
you lift your hands up for a split second, long enough to let the chest recoil.
Begin forceful chest compressions at a rate of 100 per minute (whose rhythm can
be remembered by humming to oneself “Stayin’ Alive” sung by the Bee
Perform chest compressions continuously until the paramedics
arrive. As it is physically tiring, if someone else is available, take turns
after each 100 chest compressions.
The CCOR technique should not be used
on drowning or drug overdose victims, who need standard CPR, or on children
under the age of eight.
Research physician Dr. Gordon Ewy and Dr. Karl
Kern, chief of cardiology at the medical school – who pioneered the lifesaving
technique – explained: “Just do your best. If you do nothing, the person is
likely to die. Studies have shown that there is almost no chance that you will
hurt the person. While it is rare that a rib will be broken during CPR, doctors
are able to repair broken ribs, but they cannot repair death.”
that cardiac arrest victims will regain consciousness nearly a quarter of the
time by CCOR if given immediately compared to 14 percent for conventional
Gasping, they said, is a sign of cardiac arrest and often occurs for
a while soon after the arrest and will continue when effective compressions are
“It is not an indication of recovery. Continue
chest compressions until paramedics arrive; gasping is a sign you are doing a
good job. The chances that a bystander could harm a person by pressing on their
chest are slim to none, even if the heart is working normally. It is better to
perform a few unnecessary chest compressions for someone with a beating heart,
rather than withhold chest compressions and circulation from someone in cardiac
The American Heart Association, which has issued new guidelines
endorsing CCOR, doesn’t recommend that laymen rescuers waste time trying to look
for a pulse. It doesn’t matter either if the patient has a pacemaker implanted
in his chest. In addition, the experts say, there is no need to remove the
victim’s clothing to perform CCOR. Laymen rescuers are protected legally, as
they are when they perform conventional CPR.
As many bystanders are
reluctant to perform mouth-to-mouth resuscitation on strangers, the CCOR
technique makes it much more likely that those who know the method will do it if
they are present at such an emergency, Ewy and Kern said.
comment, the Health Ministry spokeswoman said senior officials “had not known”
about CCOR until The Jerusalem Post sent them information from the University of
Arizona. She checked and found that MDA is “aware of it and using it in
first-aid courses,” but acknowledged that the new information had not been
disseminated by the ministry or MDA to the Israeli public.
Ministry said it was interested in putting a link on its website to the
University of Arizona video, but does not have the funds to run public service
announcements on television on the issue.