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Cardiocerebral Resuscitation (CCR)

Continuous compressions may be implemented in Ontario services, it is currently being tested in Peel region. This article details the physiological and theoretical information supporting the use of continuous compressions in what is known as “Cardiocerebral Resuscitation – CCR”. The information is relevant to both bystanders and EMS providers. Many countries have implemented CCR into their first aid, while some have begun using CCR as a standard for emergency medical personnel.
Continuous Compressions are to be used for cardiac arrest only (not the cause of drownings, electrocutions, etc) and on those 16+ years old.

Survival rates of cardiac arrest decrease with 30:2 CPR for 3 reasons:

1. Bystanders refused to help because they would have to perform mouth-to-mouth (infectious diseases), and
2. The length of chest compression interruption was too long
3. Common incorrect ventilation leading to emesis

Interruptions to chest compressions of any length decrease blood flow to the brain.

Recommended changes to EMS are based on coronary and cerebral perfusion rates. These changes stem from the same reason stack-shock protocols were changed: too long of an interruption in compressions. The recommendations include: 200 continuous compressions prior to 1 shock and immediately going into the second 200 compressions without stopping to check the outcome of the shock. No Intubation due to the lengthy interruption to compressions. Use of OPA and NRB and discontinued PPV (PPV increases the intrathoracic pressure causing a decrease of venous return to the thorax – resulting in decreased coronary artery perfusion and changed intracranial pressure causing decreased cerebral perfusion)

For more information see the article itself:
http://content.onlinejacc.org/cgi/reprint/53/2/149.pdf

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One Response to Cardiocerebral Resuscitation (CCR)

  1. Pingback: Digest #1, June: Training for the Road | EMS Student

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