CPR just got a whole lot simpler at the University of Wisconsin: If a victim has no pulse, skip the mouth-to-mouth and start chest compressions to the beat of “Another One Bites the Dust.”

Following the tempo of virtually any popular song will help prevent caregivers from performing compressions too fast, said UW Hospital physician and Madison Fire Dept. Medical Director Dr. Darren Bean, who is spearheading a countywide effort by local emergency medicine practitioners.

Local emergency medicine practitioners, led by Bean, are spearheading a countywide effort to increase the use and effectiveness of cardiopulmonary resuscitation.

“We are dead in the water,” in regards to CPR, Bean said. "Over half of cardiac arrest victims do not get CPR on scene because people are afraid to do (mouth-to-mouth) ventilation."

The new approach to CPR, which is part of a broader Surviving Cardiac Arrest Systems Program, eliminates mouth-to-mouth breathing from the technique in light of research suggesting mouth-to-mouth breaths are ineffective.

Physicians hope the simpler method will promote the use of CPR on a victim in the critical minutes before medical help arrives.

A cardiac arrest victim who doesn't receive chest compressions on scene has "essentially zero chance of survival," according to Dr. Kyle Martin, who is the Medical Director of Emergency Services at St. Mary's Hospital.

Early and vigorous CPR is the most important component of emergency care, and the "piece of the puzzle most often left out," he said.

If community members and first-responders like police and fire personnel aren't required to give breaths, "more people do CPR, and more people survive," Bean said. "Every single cardiac arrest we respond to on campus should have ongoing, perfect CPR," he said.

The new method also promotes more effective CPR, Bean said. Beginning immediate chest compressions helps move oxygen-rich blood to the brain, and compressions also expand the lungs for passive ventilation.

Cardiac arrest is primarily a blood flow problem, Martin and Bean explained. Mouth-to-mouth breathing is often unnecessary — the blood from the victim's lungs already has oxygen in most cases of cardiac arrest — and the procedure interrupts lifesaving compressions.

Breaths also generate pressure in the chest that can stop circulation, causing death by hyperventilation.

Expanding the idea

Three years ago, Rock County began advocating aggressive, compression-only CPR in a similar outreach program.

Since then, the percentage of victims who suffered the most common type of cardiac arrest, but survived without brain injury increased from 8 to 40 percent, according to Rock County Medical Director Rick Barney.

The Dane County program will go further than the Rock County effort by revamping cardiac arrest treatment in the ambulance and emergency room, as well.

Under the program, rescue workers will rely less on automatic external defibrillators (AEDs), which deliver an electric shock to restart a victim's heart.

The devices generally take 30 to 40 seconds to analyze heart rate and deliver the shock, time that is "critically important" to keep blood flowing to the brain with compressions, Bean said.

The new program aims to reduce the time between stopping CPR and shock delivery to five seconds by training emergency medical technicians to analyze heart rate themselves.

Police will be trained to use AEDs only immediately after they've seen someone collapse from cardiac arrest, or after they have done performed compressions for two minutes.

The last component of the effort is designed to prevent secondary brain injury. Most people who suffer cardiac arrest survive initially, but later die in the hospital from brain injury caused by lack of oxygenated blood, according to Bean.

Under the new program, paramedics will be trained to use cold saline solution to slow down metabolism and stop the cascade of events that leads to brain damage. This induced hypothermia can halt the forest fire-like spread of brain injury, he said.

"Inducing hypothermia in the first 24 hours after cardiac arrest improves the probability of good neurologic outcome," he said. "We want people walking home."

Most importantly, the new approach will improve coordination between levels of care by banding rescue workers and the three major hospitals in Dane County together under the program, Bean said.

"Wherever you go, you should get the same standard of cutting-edge care in that first 24 hours," he said.

The Badger Chapter of the American Red Cross, which teaches lifesaving techniques to an average of 45,000 citizens in Dane and six other nearby counties each year, last changed the CPR and AED training it provides in 2006.

The change in CPR, which moved from 15 compressions to 30 compressions for every two breaths, corresponded to recommendations put out by an international group of medical experts every five years.

"The use of compression-only CPR has significant benefit for persons suffering from cardiac arrest," but only those who are unwilling or untrained to do full CPR should forgo the breaths, according to the Red Cross guidelines.

"We're focusing more on the compressions while still providing breaths and doing a little faster pace" of 100 compressions per minute, said Red Cross Sales Manager Christine Kelm, who coordinates group CPR training for the Badger Chapter's Health and Safety Services Dept.

In addition, the Red Cross changed its AED training to allow for one shock followed by a two minutes of CPR, instead of the previous method of three shocks with a minute break for CPR.

The Red Cross will not change the lifesaving techniques it teaches before the next set of recommendations comes out around 2010, Kelm said.