Chest-Compression-Only CPR (CCO-CPR)

Data from the first intentional effort to encourage and endorse CO-CPR by lay individuals showed that survival rates for patients with out-of-hospital cardiac arrest are better when bystanders do CO-CPR, compared with CPR that calls for chest compressions interrupted by mouth-to-mouth “rescue breaths.” Sarver Heart Center’s Resuscitation Research Group published this Arizona data in the Oct. 6, 2010 issue of the Journal of the American Medical Association (JAMA), which validated the group’s decades of research and advocacy.

The study’s major findings include:

The most important findings of this analysis are the differences in survival rates of individuals who had the greatest chance of surviving—those whose collapse was witnessed and who had a heart rhythm that could be restored by a defibrillator shock. In these patients, 18 percent survived when conventional CPR was performed and 34 percent survived when chest-compressiononly CPR was performed.  In addition:

  • The rate of bystanders becoming involved with CPR for patients without-of-hospital cardiac arrest increased significantly from 28 percent in 2005 to
    40 percent by the end of 2009.
  • Of those performing bystander CPR, the use of CO-CPR
    rose from 20 percent in 2005 to 76 percent in 2009.
  • A significantly greater percentage of cardiac arrest victims survived in the
    chest-compression-only CPR group (13.3 percent) compared to those in the
    conventional CPR group (7.8 percent).
  • The UA Sarver Heart Center Resuscitation Research Group first advocated chest-compression-only CPR in Tucson in 2003. As part of the Save Hearts in Arizona Registry and Education (SHARE) program  (,  a statewide effort was launched in Arizona in 2004.

“In 2004, fire departments, EMS ambulance companies and hospitals across Arizona all made an enormous collective efforts to teach chest-compression-only CPR to their communities for free. This has resulted in hundreds of lives saved in Arizona,” says Bentley J. Bobrow, MD, lead author and medical director of emergency medical services at the Arizona Department of Health Services and member of the Sarver Heart Center Resuscitation Research Group.

“This statewide chest-compression-only CPR effort was an integral part of the overall efforts to improve survival of patients with out-of-hospital cardiac arrest that also included new recommendations for paramedics and hospitals,” says Karl B. Kern, MD, co-author, chief of cardiology at the UA College of Medicine and chair of the Sarver Heart Center Resuscitation Research Group.

“The importance of this study as well as our other studies cannot be overstated. Out-of-hospital cardiac arrest claims the lives of an estimated 300,000 Americans each year. If chest-compression-only CPR and other protocols of cardiocerebral resuscitation were implemented nationally, an estimated 11,000 lives could be saved each year in the United States alone,” says Gordon A. Ewy, MD, Director of the Sarver Heart Center. ♥

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