In the past couple of years, the American Heart Association’s emphasis on CPR has been on the chest compressions, rather than the traditional method that also includes rescue breathing. The AHA’s message boils down to this: if you witness a teen or adult suddenly become unconscious, call 911 and start pressing hard and fast in the center of the victim’s chest (to the beat of the disco song “Staying Alive”.) A recent study was published in Resuscitation (Current knowledge of and willingness to perform Hands-Only CPR in laypersons) which demonstrated that while less than 20 percent of laypersons knew about hands-only CPR, around 75 percent would be willing to perform it on a stranger. However, since four out of five cardiac arrests happen at home, the life you save is more likely to be someone close to you- not a random stranger. Effective CPR doubles or triples the victim’s chance of survival. As physicians, we can help educate our patients about Hands-Only CPR via posters in exam rooms or perhaps a link on our website to the AHA one minute video.
Taking it one step further, how many of you have been trained on automatic external defibrillators (AEDs)? I will confess that this week was my first instruction on an AED, though obviously in my medical training I had used standard defibrillators. AEDs are virtually everywhere in our communities- at schools, health clubs, malls, grocery stores, churches, golf courses, airports, and restaurants. Although the specific laws vary from state to state, AEDs are now required in many public facilities. While an AED is simple to use, the old med-school dictum of “see one, do one, teach one” certainly has given me a much higher comfort level the next time I witness an arrest.
Systematic reviews have repeatedly confirmed similar predictors of survival from out-of-hospital cardiac arrest; primarily that survival is better in the setting of a witnessed arrest (whether it is a bystander or EMS), and when chest compressions are deeper and faster (goal of at least 100 compressions/minute.) Unfortunately, overall survival from cardiac arrests outside of the hospital has not changed in the past several decades; it remains at 7.6%.
If you have not yet been trained, taking a brief AHA course would be ideal. Meanwhile, if you have an AED at work, we would like to encourage you to at least take 5 Minutes to literally open up the machine and familiarize yourself with the procedure. And bring a colleague.
Jill Grimes, MD, FAAFP
Family Physician, Author & Educator