Survival rates of out-of-hospital sudden cardiac arrest doubled with the use of a new resuscitation protocol, reports a study in the May 19 issue of Circulation. Despite resuscitation efforts by emergency medical services (EMS), as many as 450,000 people die of sudden cardiac arrest each year in the United States. The new protocol instructs EMS personnel to raise the compression-to-ventilation ratio from the previously recommended 5:1 to 50:2 and to delay intubation, thereby increasing spontaneous circulation. The survival rate increased from 22% under the old resuscitation method to 44% with the new protocol. Moreover, most patients had a good neurologic outcome.