The No. 1 Number: 911 : CPR buys time for victims of cardiac arrest, but by itself may not save them, experts say. Dialing for help--quickly--can.

The Seahawks were about to kick off at the Kingdome in Seattle when a fan clutched his chest and fell to the ground.

As the football tumbled through the air, a group of fans turned their backs on the play and rushed to the stricken man. As one rescuer began pumping his chest, others lined up to take over.

“They were standing around, saying, ‘It’s my turn now, it’s my turn,’ ” recalls Dr. Michael Copass, medical director of paramedic service for Seattle, where one out of every three citizens--including all cab drivers and Kingdome beer vendors--is trained in cardiopulmonary resuscitation.

But that wasn’t what saved the fallen fan’s life. It was the call someone made to 911.

According to new guidelines from the American Heart Assn. and the American Red Cross, if you want to save a life, the first step is to pick up the phone.

Although chest compressions and mouth-to-mouth breathing may prevent immediate brain damage, medical experts now agree that CPR alone does not save the lives of most adults whose hearts have stopped. What they need is defibrillation--the application of 8,000 volts of electricity to jump-start quivering heart muscle--and for that, only an equipped ambulance or fire truck will do.

Throughout Los Angeles County, that means knowing 9-1-1 and it means dialing those numbers first--even if it requires leaving the victim unattended to do so.

“Unless this is an infant or a child, the first thing you should do if you come across an unconscious person is to pick up the phone,” says Dr. Samuel Stratton, medical director of Los Angeles County’s emergency programs. “CPR buys time. But by itself, it is not going to save the lives of most adults who go down.”

If the victim is a child, the first step should always be to clear the airway and start CPR, including the Heimlich maneuver of repeated abdominal thrusts. “Children don’t stop breathing because they’ve had a heart attack. They stop breathing because they are in respiratory failure from pneumonia or trauma or drowning or something stuck in the throat,” Stratton says.

But for adults who collapse, summoning professional medical help is more urgent than beginning CPR, say Stratton and others who helped prepare the new guidelines, which resulted from research that showed CPR alone was not saving many adult lives.

For a cardiac arrest victim to survive, CPR has to be started within four minutes and medical rescuers must jolt the heart with a defibrillator within eight minutes, experts say.

When basketball star Hank Gathers collapsed in 1990 on a Loyola Marymount University court, two physicians rushed to his aid. But it was not until a trainer arrived with a defibrillator--a disputed number of minutes later--that an effort was made to shock his heart back into normal rhythm. Gathers’ family charged that the athlete might have been saved had he been defibrillated sooner.

When CPR is combined with timely use of a defibrillator, Stratton says, the results can be near-miraculous. “A few years ago, a man in his 40s--a surfer and a businessman in the San Pedro area--walked out of the bank and just collapsed. A friend immediately started CPR in the parking lot while another witness rushed to call 911. By the time he got to the hospital, (his friend) had trouble convincing him he’d nearly died,” Stratton says. “In fact, he’d been dead for nearly a minute.”

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The key to survival for cardiac arrest victims is how quickly a defibrillator reaches their sides.

In Los Angeles County, the survival rate is 4.9%--about half the national average, but well above that for other major U.S. cities. In New York City, only 30 out of 2,329 of cardiac arrest victims who were resuscitated survived and left the hospital, researchers reported last month in the Journal of the American Medical Assn.

That study found that it took an average of 11.4 minutes for the city’s emergency medical personnel to arrive and that the first electric shock from a defibrillator was administered on average in 12.4 minutes--generally too late to do any good. In Los Angeles County, it generally takes eight minutes or less--”a very respectable time for a huge urban system like ours,” Stratton says.

“Here in the city . . . our average response time is about 5 1/2 minutes,” says Chief Alan Cowen of the fire department’s bureau of emergency medical services. “But we can’t help anybody until they let us know they need help, until they call 911.”

And, sometimes there are personal, even cultural roadblocks to emergency care. “Some people are afraid of catching a disease if they help a stranger who is down,” Stratton says. “For them, we suggest first calling 911 and then if they don’t want to do mouth to mouth, just do the chest compressions. Or use a sock or a shirt between your mouth and theirs.”

Milton Urquilla, community relations officer for the Los Angeles Fire Department, says some immigrants may be reluctant to call authorities for fear they will be questioned about whether they are in this country legally. “This is not something we do here. If you call us at 911 for help, we only want to help. We are not there looking for anything or anyone else, only to provide emergency care.”

But the overriding reason many witnesses to cardiac arrests or accidents don’t help is their fear of doing something wrong or of hurting the victim. “I can tell you from personal experience that fear strikes us all,” says Stratton, who rescued his 5-year-old son from the family swimming pool.

“I am an emergency physician who uses CPR almost every shift, but when I had to use it on my own child, I couldn’t remember how to begin. . . . So I just started pumping and blowing, pumping and blowing in no particular order at first and it worked. That boy is a healthy 19-year-old today.

“The message is, just do something ,” Stratton says. “The victim is essentially dead as it is. Pretty much anything you do will help. It’s great if you can learn CPR and use it. But you can still save a life. The first and best thing to do is call 911. And do it fast.”

6 Steps to Saving a Life

Although CPR alone is not enough to save lives in most cardiac arrest cases, it can buy time until emergency medical help arrives. According to the “American Heart Assn. Basic Life Support Heartsaver Guide,” you should take the following six steps.

Shake and shout: Shake victim and shout “Are you OK?” Call victim’s name if you know it. If no response, call 911 or local emergency number.

Head tilt, chin lift: To clear victim’s airway, tilt head back and lift chin up.

Two slow breaths: If victim is not breathing, blow two long (two-second) breaths into mouth. If chest does not rise, do Heimlich anti-choke maneuver to clear airway.

Check pulse: If there is carotid (neck) pulse but no breathing, continue giving mouth-to-mouth, one breath every five seconds.

Pump chest: If no pulse, pump chest 80 to 100 compressions per minute, followed by two slow breaths.

Don’t stop: Repeat until emergency rescue squad arrives or victim regains consciousness.