Cardiac arrest is a sudden, unexpected event in which the heart stops beating, leading to the cessation of blood flow to the brain and other vital organs. If left untreated, cardiac arrest can result in death within minutes. It is estimated that approximately 350,000 people in the United States experience an out-of-hospital cardiac arrest each year, and most do not survive.
Dr. Anezi Uzendu, an interventional cardiologist, is one of the lucky few who survived an out-of-hospital cardiac arrest. In 2016, Uzendu, then a medical resident, was playing basketball at a gym in Birmingham, Alabama, when he suddenly collapsed. His heart had stopped beating, and he was not breathing.
Fortunately, Uzendu was surrounded by people who recognized that he was having a cardiac arrest and took swift action to save his life. They performed CPR and used a defibrillator to shock his heart twice before emergency workers arrived. The efforts of the bystanders and emergency workers saved his life, and he was discharged from the hospital three weeks later.
Uzendu's experience highlights the importance of bystander intervention in saving lives during cardiac arrest. Medical experts refer to the steps required to save someone who has a cardiac arrest outside of a hospital as a "chain of survival," and the first link in that chain is recognizing the problem and taking action.
According to Mary Newman, president and CEO of the Sudden Cardiac Arrest Foundation, the most important thing that a bystander can do is to recognize the issue and act quickly by calling 911, performing CPR, and using an automated external defibrillator (AED) if available.
However, recognizing cardiac arrest can be difficult, as it does not always present as a heart problem in the movies, where someone might dramatically clutch their chest and swoon. Moreover, there is often confusion between cardiac arrest and a heart attack, which are two different conditions. A heart attack is often likened to a plumbing problem, where blood flow to the heart muscle is stopped, while cardiac arrest is an electrical issue in which the heart stops beating properly.
Newman emphasized that when someone has a heart attack, they are typically awake, and their heart is beating, so they do not need CPR; they just need to call 911 and get help. In contrast, when someone has sudden cardiac arrest, their heart has stopped, and if no one intervenes quickly, they will die.
According to Uzendu, for lay responders who do not have medical training, recognizing cardiac arrest comes down to two questions: "Are they responsive? And are they breathing normally?" Checking responsiveness is as simple as tapping the person on the shoulders. Many bystanders, however, are confused by "agonal breathing," which is strange, intermittent breaths that are very short and shallow, or one large breath followed by a long period of no breathing at all.
Agonal breathing can come in many variations, but according to Uzendu, "if you notice their breathing isn't normal or not present at all, that should be a trigger to think this person is having a cardiac arrest." Sometimes, cardiac arrest can also cause jerking movements that may be mistaken for a seizure, which can slow people from responding.
Uzendu emphasized that if you see someone collapse, you should not waste time pondering the possible causes. For every minute that someone does not receive CPR and does not get an AED to shock them out of an abnormal rhythm, survival drops precipitously. Having a bystander perform CPR can double or triple the chances of someone surviving.
Doctors never determined why Dr. Uzendu went into cardiac arrest, but he's aware he beat the odds. Lay rescuers administer CPR in only about 39% of out-of-hospital cardiac arrests, and only about 12% of those patients survive, according to the American Heart Association. That means that less than 5% of those who suffer an out-of-hospital cardiac arrest survive to leave the hospital.
The coronavirus pandemic made things even tougher, as many people became reluctant to come to the aid of strangers, fearing they might contract the virus.
But now that many have been vaccinated, it's time to get back to being good Samaritans, Newman said.
As Uzendu sees it, the more people who know what to do, the better. After all, he's one of the lucky ones.
"The fact that I'm here and able to tell my story and become a cardiologist is just a miracle," he said. "It shows you the power of the human spirit and the power of medical intervention."
Learn, Enjoy, and Save Life. Healthforce Training Center offers CPR Training and certifications such as Basic Life Support (BLS), Advance Cardiovascular Life Support (ACLS), Pediatric Advance Life Support (PALS), CPR AED, Pediatric First Aid CPR AED, and First Aid CPR AED.
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