His guest blog is written by Robert Sanchez, M.D., FACC. Sanchez has been in leadership roles with the American Heart Association for more than a decade.
Doctors across the country routinely have unfortunate conversations that prove how important it is for people to know CPR – and to use it.
The discussions usually go something like this:
Emergency Room Nurse: “A 52-year-old man who was just transported to the emergency room after suffering an out-of-hospital cardiac arrest. The patient was witnessed to collapse at home. Emergency medical services responded within 5-6 minutes. Upon EMS arrival, advanced cardiac life support was initiated and the patient was eventually successfully resuscitated. His vital signs are currently stable; however, he remains comatose.”
Cardiologist: “Was CPR performed prior to EMS arrival?”
Emergency Room Nurse: “No.”
Each year more than 350,000 Americans die suffer out-of-hospital cardiac arrest, with nearly 90 percent of them fatal.
In these instances, it’s important that bystander CPR is immediately performed – chances of survival can double or triple.
That’s why the American Heart Association is working to train all Americans in Hands-Only CPR. Although bystander CPR can increase the chance of survival, fewer than half of cardiac arrest victims receive it.
Nearly 70 percent of out-of-hospital cardiac arrests occur at a home or residence. So if you have to give CPR, it more than likely will be to save someone you know and love. For every minute CPR and defibrillation is delayed, survival decreases between 7 percent and 10 percent. The brain can only survive a few minutes after the heart stops. Without early CPR, the risk of severe brain injury increases even if the victim is ultimately resuscitated.
Why the low rates of bystander CPR?
There seem to be three general reasons:
Lack of knowledge (training) or lack of confidence.
Fear of performing CPR incorrectly and causing injury to the victim.
Reluctance to give mouth-to-mouth resuscitation to strangers.
Let’s address each of these:
The American Heart Association is training Americans around the country in the two simple steps of Hands-Only CPR.
Hands-Only CPR is CPR without the rescue breaths. Studies have shown that Hands-Only CPR is as effective as CPR with breaths in the first few minutes after a witnessed sudden cardiac arrest. After someone collapses following cardiac arrest, his or her blood contains enough oxygen to supply the vital organs for the first few minutes. It is therefore important to pump this oxygen to the heart and brain.
You can perform Hands-Only CPR with just two easy steps:
Call 911 and
Push hard and fast in the center of the chest at a rate of 100 to 120 beats per minute. This is approximately the beat of the Bee Gees classic disco song “Stayin Alive.”
We can also increase confidence and knowledge through community education programs, and by requiring schools to train students in CPR before high school graduation, which creates the next generation of lifesavers.
The fear of performing CPR incorrectly or potentially causing injury to the victim is understandable. But we know the chances of survival are nearly zero unless someone acts immediately. Citizens who perform bystander CPR are protected under the Good Samaritan Law – a law that prevents a person from being liable for injury if that injury is caused while trying to help save a life.
While mouth-to-mouth is still encouraged for specific cardiac arrest and drowning victims, as you learned earlier, Hands-Only CPR is an acceptable first response in most cardiac arrest instances.
Improving the rates of cardiac arrest survival in our communities requires the development of robust systems of care in our communities.
This includes effectively implementing the "chain of survival,” which has five links:
Immediate recognition of the cardiac ar