How to restart a heart: Be prepared to help cardiac arrest victims
Many people know someone who has suffered a cardiac arrest, but what is it exactly? Cardiac arrest is the sudden cessation of pumping of the heart muscle due to one of a number of causes. A heart attack or myocardial infarction is one such cause but certainly not the only one. The survival from cardiac arrest - which occurs without warning, and whose victims are usually in their 50s or 60s - is very low.
The reason for this poor outcome is that most people don't know what to do when confronted with someone in cardiac arrest. The two factors that improve survival after cardiac arrest are CPR started as soon as possible after collapse, and use of a defibrillator, also called an AED, to restore the normal heart rhythm. Both of these procedures can be performed by a layperson. Starting CPR immediately while the paramedics are en route is critical for survival in these patients.
CPR, or cardiopulmonary resuscitation, was developed in the 1950s; however, in 2010, the protocol has undergone changes reflecting data from outcome studies that show mouth-to-mouth breathing is no longer required. The important thing in CPR is to perform rapid, deep chest compressions to circulate blood to the brain until help arrives. Many cities offer "dispatch-assisted CPR" to guide bystanders in the use of CPR.
The other factor that significantly improves survival is use of a defibrillator or AED. Many public buildings such as colleges, businesses, airports, casinos, and government offices have installed AEDs. These devices are to be used by the public during a cardiac arrest situation. It is not necessary to have taken a course to be able to use an AED since the device itself instructs the user during the procedure. Basically, two pads are placed on the chest of the victim and the device delivers a shock.
If the shock is successful and heart rhythm returns to normal, then the heart resumes pumping blood and CPR is no longer necessary. But if spontaneous circulation is not restored, you should continue CPR until help arrives.
Survival from cardiac arrest depends upon where it occurs. For instance, if it occurs at home with no bystanders, survival is very unlikely. Some communities have better survival outcomes than others due to the numbers of laypeople who are trained in CPR. In fact, in Arizona, the prehospital survival rate is higher than in other areas of the country because of continuous CPR, the availability of AEDs and newer procedures implemented by EMTs.
What can you do to be prepared in a situation where you witness a cardiac arrest? Get basic CPR training at a hospital, health fair, senior center or college. Learn the locations of AEDs in your workplace, gym, or mall and don't be afraid to use it. Like a fire extinguisher, it is there to be used by laypersons to prevent a catastrophe.
Check out YouTube videos at www.youtube.com/watch?v=j1ExB8yCxc8 and www.youtube.com/watch?v=nxpYuVr53zQ. If you are interested in learning more, see https://class.coursera.org/rosc-001/class/index.
Robin Fleck, M.D., is a board-certified dermatologist and internist. She is founder and medical director of Vein Specialties and Body Oasis Medical Spa, and is the director of Southwest Skin and Cancer Institute. Send questions via www.rejuvadoc.com.