American Heart Association officials say a unified effort by the public, educators and policymakers is necessary to reduce deaths from sudden cardiac arrest by increasing the use and effectiveness of cardiopulmonary resuscitation.
An AHA press release indicates that in many communities, only 15 to 30 percent of out-of-hospital cardiac arrest victims receive bystander CPR, and each passing minute, the victim's chance of survival falls by an estimated seven percent to 10 percent. This constitutes a tremendous risk for persons with heart disease, as well as those with common risk factors.
"Bystander cardiopulmonary resuscitation rates are woefully inadequate, resulting in an enormous missed opportunity to save lives from cardiac arrest," said Benjamin S. Abella, M.D., M.Phil., clinical research director for the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia, and lead author of the statement.
Although automated external defibrillators, also known as AEDs, have become more available in recent years, Abella says defibrillation is just one link in the chain of survival. The four essential links in the chain of events that ultimately saves cardiac arrest victims are (1) early recognition of the emergency and phoning 911 for EMS, (2) early bystander CPR, (3) early delivery of a shock via a defibrillator if indicated and (4) early advanced life support and post-resuscitation care delivered by healthcare providers.
"Quick initiation of CPR, as well as providing high quality CPR, is crucial to survival," Abella said. "What's needed is a two-pronged approach: first, substantially increase the number of bystanders trained in CPR who then provide CPR during an actual emergency and second, improve the quality of training and actual CPR performance through measures of its effectiveness."
"In communities where widespread CPR training has been provided, survival rates from witnessed sudden cardiac arrest associated with VF have been reportedly as high as 49 percent to 74 percent," Abella said. "Unfortunately, on average, approximately six percent of out-of-hospital sudden cardiac arrest victims survive to hospital discharge in the United States."
Specific recommendations in the recently published statement include:
- Local, state and federal government agencies should provide CPR education in such settings as school systems and government-funded hospital and clinic systems.
- Communities should create and support emergency dispatcher-assisted CPR training programs with an emphasis on recognizing the symptoms of cardiac arrest.
- The public should understand that when bystanders perform CPR immediately, the victim's chance of surviving cardiac arrest can double or triple at little risk to the rescuer.
- The public should be made aware of Good Samaritan laws through CPR training materials and by including information with community AEDs.
- Community lay rescuer and EMS programs should include a process for continuous quality improvement that includes a review of resuscitation efforts, quality of CPR and CPR instructions provided to bystanders by dispatchers. CPR instructional programs should always include an objective CPR quality assessment for certification.
- Research funds should be targeted toward improving methods of CPR education, skill retention and creative methods to widen the scope of current CPR training and education.
Matthew Clarke - Born and raised in Northern California, Matthew Clarke is the product of summer campouts on the Sierras, briskly sunny Christmas mornings ...
