BELOIT — Nearly four years after Rock and Walworth counties implemented a hands-only CPR protocol for paramedics and EMTs, the American Heart Association is recommending the technique for use nationwide.

“Their recommendation was wonderful,” said Dr. Michael Kellum, emergency services director at Mercy Walworth Hospital. “It didn’t go far enough, but it’s a first step.”

Kellum was instrumental in implementing the hands-only — or call-and-pump — demonstration project in the two counties, and saw an immediate improvement in the survival rates of those suffering heart attacks.

In fact, the figures are startling. In the more than three years that emergency responders in Rock and Walworth counties have been using the hands-only method, the survival rate — with neurological function intact — has gone from 15 percent to 48 percent.

“Everyone who’s touching this is learning that it works,” Kellum said.

Two Beloit residents discovered exactly that earlier this year. When a coronary blockage caused Dennis Spangler, an assistant manager at Tilley’s restaurant, to pass out at work in late January, bar manager Teresa Donovan stepped in and started doing chest compressions.

“I had just recently heard,” she said, that rapid chest compressions are more successful than traditional CPR. “I just heard in passing that the compressions were important.”

Donovan did rapid compressions for five minutes, until Beloit paramedics arrived on the scene. And Spangler couldn’t be more grateful.

“I call her my guardian angel, because I’m actually lucky to be alive,” he said.

Kellum and Dr. Richard Barney of Beloit Memorial Hospital spearheaded the local project after meeting with an Arizona cardiologist who became convinced that traditional CPR was not saving enough people. Area paramedics now are taught to focus on chest compressions, which keep blood flowing to the brain, rather than mouth-to-mouth breathing. Those who have used the new technique are impressed with the results.

“The first time you see it work — you get a (heart) rhythm back before you get through the emergency room doors — it’s a fantastic feeling,” said Lt. Scott Smith of the Beloit Fire Department.

Barb Kuska, EMS coordinator for Beloit Memorial Hospital, said emergency workers are “excited” about the success rate of the procedure, “especially at first, when they started getting more survivors — more and more people coming back.”

Hands-only CPR uses rapid chest compressions — 100 per minute — exclusively, and does not require mouth-to-mouth breathing. The method also is referred to as call-and-pump, because people are urged first to call 911, and start pumping on the victim’s chest.

On March 31, the heart association issued a statement and published an article online in its research journal “Circulation,” explaining that it is now endorsing hands-only CPR to lay people, or those who are not medical professionals, as an alternative to traditional CPR. The AHA is not recommending the method for babies, drowning victims or victims of asphyxia or drug overdoses.

Tim George, a national spokesman for the heart association in Minnesota, said the change in guidelines is necessary because many people are hesitant to perform traditional CPR, which requires mouth-to-mouth contact.

“We have an issue out there — people aren’t performing CPR,” George said. “As a call to action, this statement was issued by the AHA.”

According to the AHA, only 27.4 percent of out-of-hospital cardiac arrest victims receive CPR from a bystander. With hands-only CPR, the AHA hopes more bystanders will be willing to help out in an emergency.

“They don’t have to do this funky put-your-mouth-on-someone’s-face stuff,” said Kellum, who believes that even those trained in traditional CPR will admit that they, too, do not like the mouth-to-mouth contact.

Even though the AHA is not scheduled to officially release new guidelines until 2010, the association believed it had enough scientific evidence supporting the effectiveness of hands-only CPR, George said.

“The change came from specific studies that were published last year,” he said, noting the AHA is amending its guidelines for lay people only. For now, the AHA regards hands-only CPR as equivalent — but not superior — to traditional CPR.

“It’s not better than … it’s as good as,” George said.
Kellum disagrees, though he is glad the AHA moved quickly to change its guidelines once the scientific evidence became clear.

“Frankly, there’s no evidence that (traditional CPR) is superior to chest compressions,” Kellum said.

Those who have been teaching the method, like Beth Natter, EMS coordinator at Mercy Janesville’s EMS training center, are glad they now can say it is officially recognized by the AHA.

“It’s allowing us to teach what we’ve taught for years,” Natter said. “This change will reach that first chain of survival.”

She noted it was sometimes difficult to explain why Rock and Walworth counties were using a CPR method not approved by the AHA.

“(It) was really a huge paradigm switch,” she said of teaching the new method.

The Badger chapter of the American Red Cross in Madison, meanwhile, developed a 45-minute noncertified course in hands-only CPR, and began teaching it this month.

“We plan to launch pretty much full-scale this summer,” said Jane Richardson, a representative of the chapter. “We’re the first Red Cross chapter in the nation to do this.” The Madison Fire Department also began using the method this month.

Emergency responders in Rock and Walworth counties, meanwhile, are thrilled the technique they’ve been using for almost four years now will be saving lives around the country.

“It will have a direct impact on survival rates … across the nation,” Natter said.