Statewide Study in Arizona Published in JAMA Show Chest-Compression-Only CPR Improves Survival

Arizona data published in the Oct. 6, 2010 issue of the Journal of the American Medical Association (JAMA) show that chest-compression-only CPR by lay individuals is associated with better survival for patients with out-of-hospital cardiac arrest compared with CPR that calls for chest compressions interrupted by mouth-to-mouth “rescue breaths.”
The statewide experience in Arizona, found that the overall survival of patients with out-of-hospital cardiac arrest was 5.2 percent without any bystander CPR, 7.8 percent when bystanders did conventional CPR with rescue breaths, and 13.3 percent for those receiving chest-compression-only CPR.
“This is the first report of results from an intentional effort to encourage and endorse chest-compression-only CPR to the public,” said Bentley Bobrow, MD, lead author and medical director of emergency medical services at the Arizona Department of Health Services and member of the University of Arizona Sarver Heart Center Resuscitation Research Group. He noted that the study identified three major findings: 
  • The rate of bystanders becoming involved with CPR for patients with out-of-hospital cardiac arrest increased significantly from 28 percent in 2005, when the statewide study began, to 40 percent by the end of 2009.
  • The rate of chest-compression-only 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 conventional CPR group (7.8 percent).
“In 2004, fire departments, EMS ambulance companies and hospitals across Arizona all said, ‘we cannot accept the current dismal survival rates from cardiac arrest in our state’ and they made an enormous collective effort to teach chest-compression-only CPR to their communities for free. This has resulted in hundreds of lives saved in Arizona,” Bobrow said.
“For us 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 no bystander CPR was performed, 18 percent survived when conventional CPR was performed and 34 percent survived when chest-compression-only CPR was performed,” said Gordon A. Ewy, MD, senior author and UA Sarver Heart Center director.
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 Research and Education (SHARE) program (, a statewide effort was launched in Arizona in 2004.
 “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 for hospitals,” said Karl B. Kern, MD, co-author, acting chief of Cardiology at the UA College of Medicine, and chair of UA Sarver Heart Center’s Resuscitation Research Group.
“The importance of this study as well as our other studies cannot be overstated,” said Dr. Ewy. “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 by emergency responders and cardio-resuscitation centers, an estimated 11,000 lives could be saved each year in the United States alone,” said Dr. Ewy.
You can learn chest-compression-only CPR by viewing a six-minute instructional video produced by the UA Sarver Heart Center on
The University of Arizona Sarver Heart Center in Tucson, Ariz., emphasizes a highly interdisciplinary research environment fostering innovative translational or “bench-to-bedside” research. Working toward a future free of cardiovascular disease and stroke, the center’s more than 150 scientist and physician members collaborate with the goal of applying new findings from the basic sciences to the clinical arena as quickly as possible.