Method for resuscitating cardiac arrest victims used in MDA courses, but not known by Health Ministry

CCOR technique more likely to be used by those reluctant to perform mouth-to-mouth resuscitation on strangers.

July 11, 2013 22:16
3 minute read.
Man carries out Chest compression CPR on dummy

Chest compression CPR 370. (photo credit: YouTube Screenshot)

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 informed.

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, 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 snoring).

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 nipples.

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 Gees).

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.”

They added that cardiac arrest victims will regain consciousness nearly a quarter of the time by CCOR if given immediately compared to 14 percent for conventional CPR.

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 being delivered.

“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 arrest.

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.

Asked to 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.

The Health 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.

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