CARDIAC CARE: JAMA Studies Push Early Intervention

      Shaving just minutes off emergency teams' response times and performing CPR before hooking up defibrillators increases the survival rate for patients suffering heart attacks by as much as 33%, according to two studies published in yesterday's Journal of the American Medical Association. The first study found that an effort to decrease to eight minutes the time for emergency teams to arrive and begin defibrillation resulted in a jump from 3.9% to 5.2% in patients who survived heart attack. Author Dr. Ian Stiell, a medical professor at University of Ottawa, said, "If a community had widespread CPR training of citizens and fire and police officials, and very rapid defibrillation, you could possibly double or triple cardiac survival rates." The second study found that giving heart attack victims 90 seconds of CPR before defibrillation boosted survival rates 25% among 478 patients in Seattle. Author Dr. Leonard Cobb of the University of Washington said that while he is unsure why CPR boosts the effectiveness of defibrillation, he speculated it might prime the heart by increasing blood flow.

Low Tech, Effective ... Feasible?
      Calling the results of the relatively low-tech, inexpensive approaches "revolutionary," Dr. Peter Stone, chair of the CPR Committee at Brigham and Women's Hospital in Boston, said, "I think we will start doing it." Stone noted that training the public in CPR would be a "massive public health challenge" Already, the Boston Globe reports, physicians have successfully lobbied to place defibrillators -- which cost about $3,000 -- in airplanes and other public places, but some emergency response teams in the Boston area lack the equipment (Tye, 4/7).