The survival rate from heart attacks would be much higher if more people knew how to perform CPR, Canadian researchers say.

Every year, tens of thousands of Canadians die from cardiac arrest because they don't receive medical treatment fast enough.

Doctors know three steps – early access to care, early CPR and defibrillation within eight minutes – all improve survival.

Dr. Ian Stiell (file photo)

The Ontario Ministry of Health asked Dr. Ian Stiell, a researcher and emergency physician at the Ottawa Hospital, to find out if advanced life support by paramedics also makes a difference. In advance life support, paramedics give heart drugs and create an airway.

• FROM OCT. 7, 2003: Expand CPR lessons in community: Ottawa doctor

Stiell's team studied over 10,000 heart patients over 10 years across Ontario. The results are considered valid for any city with up to one million residents and a rapid defibrillation program, the researchers said.

"We found that in the typical setting such as we see in Ontario, the advanced care paramedic program did not make a difference," said Stiell.

"On the other hand, we found that early CPR by bystanders and rapid defibrillation by firefighters were both terribly important and make a huge difference to survival."

Study backs importance of learning CPR

Cardiopulmonary Resuscitation

A first aid procedure for an unconscious person whose breathing and/or pulse have stopped because of a heart attack, drowning, electrocution, drug overdose or other reason. Created in the 1950s by Peter Safar, and first described in the book ABC of Resuscitation, in 1957. The "ABC" is Airway, Breathing and Circulation. Standards set by the American Heart Association and the Heart and Stroke Foundation of Canada.

In Ottawa, about 55 per cent of paramedics have the advanced training. "We need the public to play their part," agreed Steve Dodge of the city's paramedic association. "To save lives, the public must learn CPR."

The head of the program supervising paramedics fears the study's conclusions may result in a diminished role for advanced paramedics.

"Some city administrator or manager ... is going to be considering whether to spend money on paramedics or on roads or some other expense, and say, 'These guys did a big study that showed that paramedics weren't of any benefit,'" said Dr. Justin Maloney.

"They'll just go looking at the abstract of the study, not the details."

• FROM AUG. 15, 2000: Mouth to mouth replaced by other techniques

Stiell said governments should put more money into public training for CPR and more automated defibrillation in the community, adding the study also showed paramedics save resources at emergency rooms.

The study appears in Thursday's issue of the New England Journal of Medicine.