Gordon A. Ewy, M.D.
More than 15 years ago, cardiologist Gordon Ewy and his colleagues at the University of Arizona's Sarver Heart Center began thinking about how to improve the likelihood that a person would survive cardiac arrest: The median survival rate for people who have cardiac arrests outside of a hospital is 7.9 percent. However, immediate bystander CPR has been shown to double or triple survival. Yet, bystanders perform CPR less than one-third of the time. Research has shown that several factors prevent bystanders from taking action, including fear that they will perform CPR incorrectly, fear of legal liability, and fear of infection from performing mouth-to-mouth.
Dr. Ewy began to research the outcomes of performing compressions without mouth-to-mouth respiration. After running successful laboratory trials, he convinced emergency-services directors in Arizona, Wisconsin and Missouri to promote the use of compression-only CPR among people in their states. Their paramedics and firefighters began using a protocol that emphasized giving chest compressions with minimal interruptions to keep the patient's blood circulating.
The results were remarkable, with survival rates for people who got only compressions better than those who received traditional CPR. When we stop breathing, the oxygen level in the bloodstream remains relatively high during the first few minutes of cardiac arrest. Dr. Ewy and his colleagues showed that uninterrupted, high quality chest compressions were important for keeping blood circulating to vital organs. Further, they found that stopping compressions frequently, such as to breathe into a victims' mouth, diminished circulation and led to worse outcomes.
Dr. Ewy and his colleagues' work has been funded for many years by the American Heart Association. "AHA grants helped to support our CPR research over the years. I was first author on four grants, and others were held by Dr. Karl Kern, Dr. Arthur Sanders and Dr. Robert Berg. These small grants from the AHA allowed us to continue our three decade-long search for better ways of doing CPR," he said.
For his contributions in defibrillation and CPR, the American Heart Association designated Dr. Ewy a "CPR Giant" at its International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in 2000. This honor is bestowed every five years on only a few individuals who have made major contributions to the field of Cardiopulmonary Resuscitation.
Editor's Note: The American Heart Association recommends that when an adult suddenly collapses, bystanders should, at a minimum, activate their community emergency medical response system (call 9-1-1) and provide high quality chest compressions by pushing hard and fast in the center of the chest, minimizing interruptions (hands-only CPR). Experts continue to promote a combination of rescue breathing and chest compressions for victims of cardiac arrest due to non-cardiac causes, like near-drowning or electrocution, and all victims of pediatric cardiac arrest. To find a CPR training class, visit americanheart.org/cpr. For more information about hands-only CPR, visit http://handsonlycpr.eisenberginc.com/