CCR, or cardio cerebral resuscitation, focuses on chest compressions to circulate oxygenated blood to the heart and brain during sudden cardiac arrest. It differs from traditional CPR in omitting rescue breaths during the first critical 5-10 minutes. CCR has been shown to improve survival rates compared to no intervention. The cardiac chain of survival emphasizes early recognition of cardiac emergency, activation of emergency services, initiation of bystander CPR or CCR, early defibrillation if needed, and advanced life support.

1. CCR
Cardio Cerebral Resuscitation
You CAN save a life!!
Presented by:
Kelly Sommerfeld
Amanda Fitzpatrick
Nick Gomez
Joni Grams
Cody Sokolik

2. Brief Background:
•CPR has been around since 1740 but didn’t gain acceptance until 1960 when
the AHA introduce it to physicians.
•CCR gained popularity and acceptance around 2008 although it had been
around dating back to 1990.
Why should I care?
•88 percent of all out of hospital sudden cardiac arrests occur at home.
•Effective CPR provided immeadiatly after SCA can double or triple the
chance of survial… Only 32 percent of SCA victims actually get CPR.
An introduction to our topic today from the
Mayo Clinic……
http://www.youtube.com/watch?v=E5huVSebZpM&feature=player_e
mbedded#!
Facts and figures courtesy of the American Heart Association

3. What is Sudden Cardiac Arrest?
 http://www.cardiacscience.com/blog/2009/06/hear
t-attack-cardiac-arrest/
 http://www.youtube.com/watch?v=zdemKH_v_aI

4. What Is CCR?
 CCR= Chest Compression-only or Cardio
cerebral Resuscitation (CCR)
 CCR protects the heart and the brain by
increasing blood flow to these organs.
 CCR eliminates the risk of over-ventilation.
 Over-Ventilation: excessive rate and depth of
respiration leading to abnormal loss of carbon
dioxide from the blood.

5. How Does it Differ??
 CCR= chest compression only
 CPR= rescue breaths and chest compressions
 CCR differs from CPR in the first 5-10 minutes after
cardiac arrest.
 CPR is performed in cycles of 30 compressions and 2
breaths, with the breaths taking 10 seconds away
from compression
 The rescuer does not breath for patient at all, instead
shifts the focus to chest compressions at the rate of
100 per minute.
 Note: Many doctors feel that CCR is more effective in
saving lives of humans that go into cardiac arrest

6. Survival in Tucson AZ
with Cardiocerebral Resuscitation
40%
30% 11/03-8/06
Hospital Discharge Survival
20%
1997-1999 25%
10% 34/136
9%
28/314
0%
Terry Valenzuela MD AHA Resuscitation Science Symposium 2006

7. Perfusion
Important Information
What: Perfusion is the process of delivery of blood to a capillary bed in the biological
tissue.
Coronary perfusion pressure correlates with the coronary blood flow and determines the
outcome during a cardiac arrest.
Re-establishing blood flow to the vital organs is the single most important factor for
successful resuscitation
How: Coronary perfusion pressure is the difference between right arterial pressure (RAP)
and aortic pressure (AoP) during diastole.
Note: Calculating coronary perfusion pressure (CPP) is an invasive technique used
primarily for research, to measure the pressure in the coronary arteries upon diastole.

8. This graph shows the percentage of patients who achieve return of
spontaneous circulation (ROSC) in response to coronary perfusion
pressure (CPP).

9. l
Normal ventricular fibrillation (heart beat) contracting uniformly
After cardiac arrest, heart response declining and contracting independently
After providing compressions, perfusion to the heart is
reestablished

11. Cardiac Chain of Survival

12. What is it?
 Was developed to help understand urgency of
help
 Developed in 1990
 By American Heart Association
 Most SCA episodes occur outside of a hospital
 Death occurs within minutes of onset
 Must be done in a quick manner

13. Early Access
 Activate the emergency response system
 Early recognition of cardiac emergency
 Call 911 as soon as possible
 The sooner the call, the sooner help will arrive
 Alert system in individual facility

14. Early CPR (or CCR)
 Should be started as soon as possible
 Should be maintained until help arrives
 At least 100 chest compressions per minute
 2 inch compression depth for adults
 1 ½ inch compression depth for infants and children
 Try to minimize interruptions
 Helps oxygenate blood flow to heart and brain

15. Early Defibrillation
 The only way to
restart someone’s
heart
 Electronic device
sends an electric
shock to the heart to
stop
 Extremely rapid
 Irregular heartbeat
 Restore the normal
heart rhythm

16. Early Advanced Care
 Provided by paramedics or other highly trained
EMS personnel
 Includes
 Basic life support
 Defibrillation
 Administering cardiac drugs
 Insertion of breathing tubes

17. Facts
 Every minute after onset of cardiac attack survival
chances are reduced by 7-10%
 Within 4-6 minutes brain damage and brain death
starts
 After 10 minutes few attempts of resuscitation
succeed
 CCR and defibrillation within 4 minutes and
paramedic within 8 minutes, survival chance is
43%
http://www.chainofsurvival.com/cos/Timing_detail.asp

18. Performing CCR
Two simple steps….
1) Call 911
2) Push hard and fast in the center of
the chest.
http://handsonlycpr.org/

19. Common Questions:
Where is the center of the chest?
What does a compression actually do?

20. Practice Time…
How will I ever remember 100 beats per minute?
http://www.youtube.com/watch?v=MJ5Z8BjQ_8A
http://www.youtube.com/watch?v=rNQRfBAzSzo