In 2003, the University of Arizona's Sarver Heart Center introduced Continuous Chest Compressions (CCC) as an effective means to deliver CPR in a cardiac arrest. When it was written up in the New England Journal of Medicine it was ground-breaking and has truly reinvented the way CPR is performed, especially for laypersons. With no need for mouth to mouth contact required for respiratory support, more laypersons are willing to "do something" for a victim of a sudden cardiac arrest. Those first few minutes are essential to survival and return to normal mental functioning after a cardiac arrest, having laypersons starting compressions as 911 is called has improved survival rates. Sarver Heart Center found an increased survival rate of over 300% when continuous chest compressions were started, 911 was called and paramedics then came to take over the resuscitation and transport the person to a hospital.

This new CPR of continuous check compression (CCC)is now termed Cardiocerebral Resuscitation.

Let's look at the CCC method and learn a bit more about it. Remember that CCC is just the layperson part of Cardiocerebral Resuscitation, professional medical care is still essential for survival and recovery from a cardiac arrest.

The basic steps for a layperson to follow should they witness someone collapse:

* Shake the person and shout, "Are you okay?". If the person does not respond and is not breathing, or they are struggling to breathe, point at someone and say, "You, call 911". If you are alone, call 911 first.

* Position the person on the floor (not on a soft surface) on their back. Kneel close to the person and place the heel of one hand on top of the other hand. Place the heel of the bottom hand on the center of the person's chest (approximately between the nipples). It is best to remove the shirt and bra so you have skin to skin contact, this lessens the chance of sliding off the breastbone and causing additional rib damage. Lock your elbows and begin to forcefully compress the chest downward at a rate of approximately 100 beats per minute (think of the disco hit "Stayin' Alive" and compress to the beat of the song). After each compression lift the heel of your hand off of the chest completely, but ensure that your hands stay directly over the sternum (breast bone).

* Many public places have an AED available - Automated External Defibrillator (it has a heart with a lightening flash symbol). Turn on the unit and follow the voice prompts. If no AED is available continue continuous chest compressions until the paramedics arrive and tell you they are taking over. The paramedics may need a few moments to set up their equipment, so do not stop until you are instructed to do so.

Remember, doing CCC is very tiring, so change over with another person if one is available. If no one else is around, continue CCC as long as you are able to do so and make every effort to continue until professional help arrives.

The above CCC method is for layperson intervention while awaiting the arrival of advanced life support in the form of paramedics. Advanced life support is still required to help improve survival rates. However, the early intervention of laypersons on the scene means more people are surviving and going on to lead full and productive lives.

Please Note: The Sarver Heart Center does recommend that in suspected drowning or drug overdose, standard CPR procedures should be followed: alternating 30 chest compression with two mouth to mouth breaths while awaiting the arrival of the paramedics.

For more detailed information, please go to the University of Arizona Sarver Heart Center page at http://heart.arizona.edu/publiced/lifesaver.htm.