CPR can double or triple a victim’s chances of survival when performed immediately
after a person suffers cardiac arrest
By: Deborah Millar, R.N.
Many people learned cardiopulmonary resuscitation (CPR) during
health class in high school, but may now only vaguely remember the procedure.
Others may have learned it when their children were born and are not sure what
do now that they are older. Still others may have been meaning to take a CPR
class after hearing about a friend or loved one who suffered a heart attack.
Whatever the reason, now is a good time to learn or re-learn
the life-saving techniques of CPR. Last fall, the American Heart Association
released updated guidelines to encourage more people to study CPR and perform
it well.
Many of the changes were meant to simplify the way that lay
people (non health-care professionals) are taught to administer CPR. The American
Heart Association says some people were concerned that not enough bystanders
were performing timely CPR, partly because they could not remember the procedure.
Sudden cardiac arrest suffered outside of the hospital or
in the Emergency Department is responsible for about 335,000 of all annual coronary
heart disease deaths in the United States, according to the American Heart Association.
However, their research shows that bystanders perform CPR in fewer than one-third
of cardiac arrests outside of the hospital.
More widespread knowledge of CPR and emergency cardiovascular
care could potentially save thousands of lives each year. CPR can double or
triple a victim’s chances of survival when performed immediately after a person
suffers cardiac arrest.
Sudden cardiac arrest can be caused by any number of conditions
such as heart attack, stroke, choking and drowning. The intent of CPR is to
keep oxygenated blood flowing to the brain and heart until advanced care can
restore normal heart function. Without CPR, tissue in the brain and heart begins
to die within minutes of when the heart stops.
Most people are familiar with the basics of CPR, even if only
from seeing it on TV and in the movies. CPR uses a series of chest compressions
and rescue breaths into the victim’s mouth to move oxygen-rich blood through
the body.
The American Heart Association’s new CPR rules are based on
its research and information from leading international resuscitation councils.
The most significant change is the recommendation that all
lay rescuers perform the same ratio of rescue breaths to chest compressions
for infants, children and adults. Previously, rescuers were taught to use different
ratios of compressions to breaths for children and adults. The change makes
the single ratio easier to remember. It was based on studies that show blood
circulation increases after each compression in a series of chest compressions,
according to the American Heart Association.
The new guidelines also advise use of the same technique for
chest compressions on children and adults. What’s most important is that the
compressions are performed properly so that the victim’s chest is compressed
to one-half or one-third of its depth.
In addition to the changes in technique, instructors are emphasizing
CPR’s role in a larger live-saving course of action called the "Chain of Survival."
The adult Chain of Survival has four steps:
- Early Access: Call 9-1-1 when you recognize an emergency and determine whether
an automated external defibrillator (AED) is readily available. - Early CPR: Without CPR, a sudden cardiac arrest victim’s chances of survival
drop 7 percent to 10 percent for every minute of delay until defibrillation. - Early Defibrillation: Many schools, airports and other public buildings
are equipped with an AED, an electronic device that can shock the heart back
into a normal rhythm. - Early advanced care: Bystanders should continue to perform CPR or operate
an AED until highly-trained paramedics or other first responders arrive.
The pediatric Chain of Survival is somewhat different. Most
adult cardiac arrest victims suffer from ventricular fibrillation, an inadequate
heartbeat that usually can only be reversed with defibrillation. Children, especially
those 8 and younger, most often become unresponsive because of a breathing emergency
caused by choking, drowning, shock or injury.
Prevention is the first step in the pediatric chain. Parents
need to be aware of choking hazards such as balloons, coins and pen caps. They
should insist that children eat only while sitting down and teach older children
not to give food or small toys to their younger siblings.
Early CPR is the second step in the pediatric chain. If a
bystander is alone, CPR should be started before calling 9-1-1. A child in respiratory
distress is much more likely to benefit from CPR than an adult with ventricular
fibrillation. Access to emergency medical services and advanced life support
are the final two steps in the pediatric survival chain.
Many people find that taking a class helps them visualize
and practice the techniques. Princeton HealthCare System’s Community Education
& Outreach Program offers a range of adult and pediatric CPR courses every
month for healthcare professionals, parents and other lay people. To learn more
or register for a class, visit www.princetonhcs.org
or call (888) 742-7496.