Cardiovascular diseases are the leading cause of death worldwide, and cardiac arrest alone accounts for almost half of these deaths. Cardiac arrests are sudden and often occur without any warning1. They are caused by arrhythmia such as irregular heartbeats caused by an electrical malfunction of the heart, causing disrupted pumping action of the heart leading to the interrupted blood supply to the vital organs. The victim then loses consciousness and pulse, which leads to sudden death if timely treatment is not provided.
Factors that affect the outcome of cardiac arrest include:
- Response time of the professional health care providers
- The cardiac rhythm of the patient
- Whether the victim received CPR
- Was the event witnessed by someone?
Unfortunately, 90% of those who experience an out-of-hospital cardiac arrest will die CPR. Timely intervention is a very crucial element in this case as the chances of survival of the victim increase by double or tripple if CPR is started immediately.
Signs and symptoms:
The suspect would show the following signs if they are suffering from cardiac arrest:
- The person is not breathing or just gasping
A person could be suffering from cardiac arrest if they become unconscious and do not breathe normally. CPR must be provided right away as it is proven to play a critical part in the survival of the victim, especially for those who suffer out-of-hospital cardiac arrest.
Order of Interventions:
Chest compressions are the critical element for the survival of the victim suffering from cardiac arrest. Follow the C-A-B sequence2. In the A-B-C sequence of CPR, the chest compressions were often delayed while the provider dealt with the complexity of maintaining the airway. Also, at times the bystanders hesitate to provide rescue breathing, and this delays the compressions even more. Following the C-A-B sequence of CPR increases the chances of survival as chest compressions are provided much sooner. Thus the sequence of CPR has been changed from A-B-C to C-A-B.
- Ensure the safety of the place you’re at.
- Check if the person responds to you. See if the person is unresponsive.
- Instantly shout for help, tell someone to call 911. Ask someone to find and bring an AED (automated external defibrillator) immediately. If you are alone with the victim and have a defibrillator in hand, bring it. Do not leave the victim to go and find the defibrillator just call, 911 ambulance will bring one.
- Check if the person is breathing if the person is not breathing or is gasping only begin CPR with chest compressions immediately. Interlock your fingers and make sure they are in the center of the chest, not touching the ribs.
- Begin CPR, provide chest compressions at the rate of 100 to 120 pushes per minute, pushing almost 2 inches down in the center of the chest. Wait for the chest to rise back before pushing again.
- Make sure the victim is lying on a firm surface.
- Open the airway by tilting the head back and lifting the chin of the victim.
- Close the nostrils of the victim with your thumb and finger.
- Blow into the victim’s mouth.
- Give two full breaths. Make sure the victim’s chest is rising and falling. If the chest does not rise and fall, tilt the head back and pinch the nostrils tightly to make sure no air leaks and blow again.
- If the chest does not rise and fall still, look for any obstruction in the airway and just switch to chest compressions as this may help to shift the object blocking the airway.
- As soon as the AED arrives, turn it on and follow the instructions.
Continue providing CPR until the person becomes responsive or the EMS arrive and take over. Even if the victim becomes responsive, leave the defibrillator attached and monitor their level of response. Stay by the side of the victim until medical help arrives.
CPR should only be stopped in the following situations:
- The person recovers and is breathing normally
- EMS or paramedics arrive and take over 3
- The person performing CPR become physically exhausted and stops
Cardiac arrest can strike anyone, anywhere at any time, without warning. Statistics show that it is the leading cause of death worldwide,so one must know how to deal with the emergency situation of a person having a cardiac arrest. The first step is to call 911, then provide CPR right away, as it has been proved that CPR plays a critical part in the survival of the victim. CPR must not be stopped until any medical help arrives. Luckily, the global survival rate of those who received CPR with out-of-hospital cardiac arrest has increased over the past 40 years4. However, it’s all of our job to ensure it continues.