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Most Americans who suffer cardiac arrest do not get prompt CPR, and that's one of the reasons that in some places survival rates are less than 10 percent. To do better, some U.S. cities are pushing a new type of CPR. NPR's Richard Knox reports.

RICHARD KNOX: The new CPR doesn't require special skills or training. It also doesn't involve mouth-to-mouth contact. All you have to do is push on the chest to keep the blood flowing until Emergency Medical Technicians arrive. That means it's a lot easier for the EMTs who answer 911 calls to coach people in how to do it over the phone.

(Soundbite of recording)

Unidentified Woman #1: All right. How is your mom?

KNOX: Like this episode. A woman in Boston has called 911 to say that her mother stopped breathing.

(Soundbite of recording)

Unidentified Woman #1: She stopped breathing?

Unidentified Woman #2: Yes.

Unidentified Woman #1: All right. Well, then if she stopped breathing I need somebody to do CPR. But I only need one person.

Unidentified Woman #2: OK.

KNOX: The call taker, an EMT, coaches the woman on how to resuscitate her 76-year-old mother.

(Soundbite of recording)

Unidentified Woman #1: All right. Well, then I need you to lay her flat on her back and start CPR.

Unidentified Woman #2: All right.

Unidentified Woman #1: One hand on top of the other, front of her chest, between the nipples, and press down.

Unidentified Woman #2: OK.

Unidentified Woman #1: All right. Now, we'll need to do that 30 times.

Unidentified Woman #2: Three, four, five...

KNOX: It seems to be working.

Unidentified Woman #2: She's breathing.

Unidentified Woman #1: If she's breathing, I don't want you doing CPR. If she's not breathing I need you to do CPR.

KNOX: Pressing on the chest isn't a good idea when somebody's breathing on her own. But the woman stops breathing again, so the EMT tells the daughter to go back to pushing on the chest.

(Soundbite of recording)

Unidentified Woman #2: Three, four, five...

KNOX: A minute later, EMTs arrive and take over.

Joe O'Hare says this is exactly how he'd like to see every case work. He's deputy superintendent of Boston's Emergency Medical Services.

Mr. JOE O'HARE (Boston Emergency Medical Services): The patient survived, when home with good cerebral performance, as far as we know. So that CPR probably saved that woman's life. So she did well.

KNOX: This could happen a lot more often. Most of the time somebody has a cardiac arrest there's somebody who could help until the EMTs arrive, but bystanders do CPR only about 25 percent of the time. Partly that's because many people aren't comfortable with the mouth-to-mouth part, called rescue breathing.

Dr. Thomas Rea of the Seattle-King County Health Department says streamlining CPR may save many more lives.

Dr. THOMAS REA (Seattle-King County Health Department): Rates of bystander CPR haven't changed a great deal in most communities in the last decade or two. By making it simpler, maybe we can move that needle a little bit.

KNOX: It's begun to work in Seattle. There, 911 dispatchers have been pushing the new CPR for the past year with good results.

Dr. REA: We saw that bystanders were more likely to get CPR started when the instructions were just chest compressions as opposed to chest compression plus rescue breathing.

KNOX: Rea led a study in this week's New England Journal of Medicine that compared nearly 1,000 cardiac arrest victims who got traditional CPR from bystanders versus 1,000 who got the new-style CPR. There was no different in survival - around 11 or 12 percent in each group.

That's not great, but Rea thinks a big difference will come if more bystanders are willing to do the new CPR. And he thinks more 911 dispatchers will be able to convince them to try.

Dr. REA: A dispatcher can say I'm going to tell you exactly what to do, let's get started. An assertive, confident dispatcher can make a world of difference. I mean, they can save lives.

KNOX: A similar study from Sweden also shows the new CPR is just as good.

Richard Knox, NPR News, Boston.

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