BYSTANDER CPR

By Audrey Fraizer

Sudden cardiac arrest is not an isolated event.

According to the American Heart Association (AHA), nearly 383,000 out-of-hospital sudden cardiac arrests occur annually, and 88% of cardiac arrests occur at home.

While effective bystander CPR provided immediately after cardiac arrest can double or triple a victim’s chance of survival, only 32% of cardiac arrest victims get CPR from a bystander. Less than 8% of people who suffer from cardiac arrest outside of the hospital survive.

And there is a difference between a heart attack and sudden cardiac arrest. A sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which cause the heart to suddenly stop beating. A heart attack occurs when the blood supply to part of the heart muscle is blocked.

A heart attack may cause cardiac arrest.

 

AHA bystander recommendations1

2010 (New): If a bystander is not trained in CPR, the bystander should provide Hands-Only(compressions-only) CPR for the adult victim who suddenly collapses, with an emphasis to “push hard and fast” on the center of the chest, or follow the directions of the EMS dispatcher. The rescuer should continue Hands-Only CPR until an AED arrives and is ready for use or EMS providers or other responders take over care of the victim.

All trained lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, compressions and breaths should be provided in a ratio of 30 compressions to 2 breaths. The rescuer should continue CPR until an AED arrives and is ready for use or EMS providers take over care of the victim.

 

Academy position

The following information stating the Academy’s position on CPR was published in the March/April 2013 issue of The Journal.

Mouth-to-mouth resuscitation

Regarding mouth-to-mouth instructions for trauma patients, this is the current standard of care—plain and simple. The AHA recommendation states it is “reasonable” for EMDs to provide a compressions-only pathway for adult arrest victims of probable cardiac origin. Respiratory and traumatic origins are still treated with compressions and ventilations.

Additionally, the incidence of contracting an infectious disease through rescue breathing is extremely low. However, one can respect the rescuer’s concern. We are only obligated to offer the current standard of care instructions; rescuers are free to refuse mouth-to-mouth in such circumstances, and they often do when blood is on the victim’s mouth, especially if the victim is a stranger. This is why we have a “Refused M-T-M” pathway.

ABOUT THE AUTHOR :
Audrey Fraizer is Managing Editor of the Journal, and is poster child for an editorial personality. She has a focused streak difficult to distract, calls library research a hobby, and believes she fools her co-workers into thinking she’s listening when she’s actually not.

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