How a Nursery Rhyme Saves Lives

By Lisa Ashley Warshaw

Michael Nealon was 34 years old when he died for the first time. His routine lunch-hour workout landed him on the gym floor, the victim of cardiac arrest.

“I don’t know how long I was dead,” Mr. Nealon said.

Co-workers called 911 and performed CPR as they waited for emergency personnel. Eventually, Mr. Nealon was resuscitated by paramedics.

Mr. Nealon, a contract manager at Oracle in Irving, is grateful to the first responders who saved his life in the early 2009 incident.

Thanks to a study run by the Dallas-Fort Worth Center for Resuscitation Research at UT Southwestern Medical Center – in conjunction with the Resuscitation Outcomes Consortium (ROC) – area emergency personnel were trained in 2008 to perform a minimally interrupted chest compression method of CPR. This method, which performs compressions at a specific, constant rate, significantly improves the chances of returning a pulse to victims following cardiac arrest, the study showed.

Dr. Ahamed Idris, Professor of Surgery and Internal Medicine at UT Southwestern, set out to discover whether the rate of chest compressions used by first responders affected the outcome of resuscitation. As it turns out, it does.

Dr. Ahamed Idris and Dallas-Fort Worth paramedics

Dr. Idris’ findings, published in the June edition of Circulation, revealed there is a “sweet spot” for the number of chest compressions per minute performed on cardiac arrest victims.

 “Performing chest compressions too slow or too fast shows a substantially lower chance of restoring a heartbeat,” Dr. Idris said. “The research indicates that a rate of 100 to 120 chest compressions per minute is exactly where you need to be in order to breathe life back into a patient.”   

Some paramedics use a metronome to keep the beat. Repeatedly singing the popular children’s nursery rhyme and song, “Row, Row, Row Your Boat,” also helps keep the rate of chest compression in the recommended sweet spot, Dr. Idris said.

The study compiles data from ROC’s coverage area of Seattle, Portland, Ore., San Diego, Dallas, Milwaukee, and Pittsburgh, in addition to the Canadian cities of Vancouver, Toronto, and Ottawa. The consortium, founded in 2004, aims to improve the outcome for victims of cardiac arrest and severe traumatic injury.

The Dallas/Fort Worth region includes statistics from eight cities, 31 hospitals, six trauma centers, and more than 5,000 first responders. Since data collection began more than six years ago, ROC’s database has compiled information from 175,000 patients, including 20,000 regionally.

Area first responders were trained on the chest compression method, and trained again. “We kept training them until we saw the results we wanted,” Dr. Idris said. “We have improved survival from cardiac arrest by more than 100 percent in our region.”

In his particular case, Mr. Nealon said he believes first responders helped him beat the odds. On casual days at work, he frequently wears a T-shirt that says, “Death. Been there, done that.”