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How long is CPR before death?

Based on the relationship between favorable brain outcomes and the time from collapse to a return of spontaneous circulation, the researchers calculated that CPR lasting 38 minutes or more was advisable.

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A new study has found that keeping resuscitation efforts going for longer could improve brain function in survivors. The sooner that CPR is started after someone’s heart stops, the better. That we can all agree on. Now, Japanese researchers report that continuing CPR for a half-hour or more may help victims survive with good brain function – even after a full 38 minutes – according to a study presented at the American Heart Association’s Scientific Sessions 2013.

But how did the researchers come to these conclusions?

They reviewed data on more than 280,000 people who had experienced cardiac arrest outside a hospital. When the patients’ hearts stopped, there had been at least one other person nearby. Next, they narrowed that large group down to those whose hearts started beating on their own after resuscitation. Doctors call this “return of spontaneous circulation.” This group included almost 32,000 people. When the researchers examined those patients 30 days after their cardiac arrest, they found that just more than 27 percent had good brain function. Those who had good brain function averaged 13 minutes from the moment their heart stopped until their heart started beating again on its own. Those with less favorable outcomes averaged almost 22 minutes of resuscitation efforts before their hearts started beating again. Some people even had favorable outcomes after as long as 38 minutes of resuscitation efforts. (via) After adjusting for other factors that can affect neurological outcomes, researchers found that the odds of surviving an out-of-hospital cardiac arrest without severe brain damage dropped 5 percent for every 60 seconds that passed before spontaneous circulation was restored. Based on the relationship between favorable brain outcomes and the time from collapse to a return of spontaneous circulation, the researchers calculated that CPR lasting 38 minutes or more was advisable. “It may be appropriate to continue CPR if the return of spontaneous circulation occurs for any period of time,” said Ken Nagao, M.D., Ph.D., professor and director-in-chief of the Department of Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University Hospital in Tokyo. This research hasn’t been officially published in a peer-reviewed journal yet, but the findings are encouraging.

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What is the chain of survival for adults?

The original four links of the chain of survival comprised: (1) early access—to activate the emergency medical services (EMS); (2) early basic life support (BLS) to slow the rate of deterioration of the brain and heart, and buy time to enable defibrillation; (3) early defibrillation—to restore a perfusing rhythm; (4) ...

resuscitationjournal.com - The chain of survival - Resuscitation

1 Cummins R.O.

Ornato J.P.

Thies W.H.

Pepe P.E. Improving survival from sudden cardiac arrest: the “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Survival from cardiac arrest depends on a sequence of interventions. The chain of survival concept emphasises that all these time-sensitive interventions must be optimised to maximise the chance of survival—a chain is only as strong as its weakest link.The original four links of the chain of survival comprised: (1) early access—to activate the emergency medical services (EMS); (2) early basic life support (BLS) to slow the rate of deterioration of the brain and heart, and buy time to enable defibrillation; (3) early defibrillation—to restore a perfusing rhythm; (4) early advanced life support (ALS)—to stabilise the patient. This chain is a prominent symbol of resuscitation services in many parts of the world. Designs depicting the chain of survival have been updated frequently, but until recently the message conveyed in each link has remained unchanged.

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