Your local first responders want to improve the survival rate of sudden cardiac arrest victims by having thousands of people trained, ready, and able to assist in saving a life. The American Heart Association reports that about 475,000 people die of sudden cardiac arrest each year. In fact, sudden cardiac arrest claims the lives of nearly 1,300 people every day. Your ability to immediately recognize the situation and to begin effective Cardiopulmonary Resuscitation (CPR) may mean the difference between life and death.
Sudden cardiac arrest is not the same as a heart attack. A victim of sudden cardiac arrest collapses suddenly, becomes unresponsive, and stops breathing. The arrest occurs when the heart’s electrical system malfunctions, resulting in irregular signals and beats that leave the heart unable to pump sufficient blood. Unfortunately, most victims of sudden cardiac arrest die before reaching the hospital. Surprisingly, many of them appear to be in good health before the collapse.
The AHA suggests that a strong Chain of Survival can improve chances of survival and recovery for victims of cardiac arrest. The AHA identified 6 links in the Chain of Survival for adult victims of sudden cardiac arrest. The first link in the chain is recognizing the signs of cardiac arrest and activating the emergency response system, or calling 911. Beginning CPR immediately with an emphasis on chest compressions is the second link. The third link is using an Automated Electronic Defibrillator (AED) to provide an electrical shock to the heart. The remaining 3 links to the Chain of Survival refer to the care provided by the Emergency Medical Services, including EMTs, paramedics, firefighters, and the medical professionals in the hospital.
Recently, an excellent example of following the first 3 links in the Chain of Survival resulted in a positive outcome. The skills and quick thinking of some local bystanders really did make the difference in someone’s life last week. The Westerly Ambulance Corps reported a successful Bystander CPR story in a recent social media post. According to the post, an individual at a public event collapsed and trained bystanders wasted no time jumping into action to save a life. Without hesitation, they called 911, performed CPR, and used an AED to defibrillate the patient just as Westerly Ambulance emergency medical crews and Stonington Police officers arrived. Within minutes, the patient had a heartbeat and was breathing. The ambulance crew then provided advanced life support during transport to the hospital where emergency room nurses and doctors and a cardiologist were waiting to provide additional care. Together, bystanders, first responders, and emergency health professionals completed the Chain of Survival for this lucky person.
Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but AHA statistics indicate that with every minute that CPR is delayed, the victim’s chances of survival fall by about 10 percent. Although thousands of people in the area have been trained in CPR, when people collapse from a sudden cardiac arrest, relatively few bystanders are willing to attempt resuscitation. According to AHA statistics, fewer than one-third of those who might be helped by CPR receive it from bystanders before firefighters and emergency medical technicians arrive.
With so many people trained and certified, why is bystander CPR not done more often? A combination of factors may be involved. People might panic, or forget the steps, or be afraid of making mistakes. Many first responders believe that the primary factor is that bystanders are simply not comfortable performing the mouth-to-mouth rescue breathing.
Given this perceived reluctance, researchers began to evaluate the effectiveness and efficiency of mouth-to-mouth rescue breathing and found, in a study published in The New England Journal of Medicine in 2010, that chest compressions alone appeared to be as good, if not better, than combining them with mouth-to-mouth rescue breathing.
Based on these findings and other studies, the AHA removed rescue breathing from bystander CPR guidelines for teenagers and adults in sudden cardiac arrest. The new program, called “Hands Only Bystander CPR,” was created in 2010 and can be taught in less than 10 minutes.
This simplified version recommends that, when encountering a person who has collapsed and is unresponsive, immediately call or direct someone to call 911 and then begin to administer rapid, forceful chest compressions until firefighters and EMTs arrive.
The Hands Only Bystander CPR process is straightforward and simple. Put one hand over the other, with fingers entwined, place them in the center of the chest between the nipples, and press hard and fast.
Each compression should depress the chest by about 2 inches and should be repeated about 100 times a minute. Many people find that pressing the chest quickly to the beat of the song “Staying Alive” by the Bee Gees will help maintain the proper rhythm and provide a bit of motivation and hope. However, you should probably sing this in your head rather than humming the tune aloud.
The great news is that you do not have to attend a course to learn Hands Only CPR. You can read through the material and watch a training video produced by the American Heart Association and learn the basic skills in less than 10 minutes. Simply search www.heart.org for “AHA Hands Only CPR instructional video.”
This column was written by Jane Perkins, fire safety specialist for the Rhode Island Southern Firefighters League and Captain of the Watch Hill Fire Department. If you would like to see a question answered in this column, please e-mail her at askafirefighter@yahoo.com.