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People who suffer a cardiac arrest in Denmark today are three times more likely to survive than a decade ago, thanks largely to a national effort to teach people CPR, a new study says.

Denmark launched a national effort in 2005 to teach its residents to perform CPR, or cardiopulmonary resuscitation, in order to save people who suffer a cardiac arrest outside a hospital. The country gave out 150,000 instructional kits; kids began learning CPR as early as elementary school. Teens were required to learn CPR in order to get a driver’s license.

The results have been dramatic, say authors of a study in today’s Journal of the American Medical Association, or JAMA. About 300,000 people in North America each year suffer a cardiac arrest, when the heart stops beating, outside of a hospital.

In Denmark, the number of cardiac arrest victims who received “bystander” CPR — from someone other than a health professional — more than doubled, from 22% in 2001 to 45% in 2010.

In the same time period, the percentage of cardiac arrest victims who arrived at a hospital alive increased from 8% to 22%.

The percentage of patients alive after 30 days tripled, growing from 3.5% to 11%. The percentage of patients alive after one year also more than tripled, from 3% in 2001 to 10% in 2010.

Those findings are impressive, says Michael Sayre, a professor of emergency medicine at the University of Washington and a spokesman for the American Heart Association.

Although other studies have looked at smaller, community efforts to promote CPR, Sayre says the new study is striking because it involved an entire country.

Thanks to efforts by the heart association, Washington and a handful of other states now require students to take a CPR class before graduating from high school, Sayre says.

Still, study authors say that Denmark’s CPR initiative can’t take all of the credit for improving survival.

That’s because Denmark also made other important changes aimed at increasing survival after a heart attack, such as improving the care provided both by hospitals and emergency medical services.

“Teaching bystanders the importance of CPR can make a difference,” says Suzanne Steinbaum, director of the program on women and heart disease Lenox Hill Hospital’s Heart and Vascular Institute, in New York.

Performing CPR is actually easier than ever, Steinbaum says. That’s because the heart association now recommends a “hands-only” CPR procedure, in which bystanders concentrate on performing chest compressions, instead of alternating compressions with mouth-to-mouth breathing.

“Those who witness a cardiac arrest and start CPR can actually change the outcome of what happens to the victim,” she says.


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