You leave your house for a quick trip to the grocery store. You see your neighbor sitting on his lawn with his lawnmower stopped and the engine running. You wave and shout a "hello" to him, but he doesn't wave back as he normally does. He looks weak and is clutching his chest. From the looks of things, you suspect that he is having a heart attack, which can lead to heart stoppage (cardiac arrest). If that happens, his chances of surviving are less than 1 in 20.
About 1,000 sudden cardiac arrest deaths happen every day! It's one of the leading causes of death in United States - about 360,000 deaths each year. It's the leading cause of adult disability.Sudden cardiac arrests take place most often in the home or in public places. Few cases take place at the worksite or at non-hospital medical facilities, such as nursing homes or doctors' offices.
One study found that 20 percent of sudden cardiac arrests occurred at five sites:
1. Airports
2. County jails
3. Shopping malls
4. Sports stadiums
5. Golf courses
The science of resuscitation is very new (since the 1960s). Medical science has and continues to develop treatments for this major cause of death and disability. Recently I attended the Emergency Cardiac Care Update Conference in Orlando, Fla., where many of the world's leading authorities revealed the latest and in some cases, disturbing information about sudden cardiac arrest. This week's column features new information about how to attempt to save the lives of those with heart stoppage or cardiac arrest.
Cardiopulmonary resuscitation (CPR) can help save lives. Those who have been trained in CPR know that before giving CPR, a check for a pulse should be done at the neck (cartoid) artery. However, disturbing information was given at the conference indicating that the neck (cartoid) pulse check is unreliable. One study found that only 8.2 percent of trained medical students and 5 percent of trained ambulance personnel could correctly identify the presence or absence of a pulse. The medical students required a mean time of 5.9 seconds (some needing up to 23 seconds) and the ambulance personnel required a mean time of 7.0 seconds (some needing up to 109 seconds). Also, only 45 percent of trained volunteers could detect a pulse and a disappointing 20 percent of anesthesiologists could feel a pulse within 5 seconds.
Optimistic reports about the effectiveness of automated external defibrillators (AEDs) were given. Television programs have acquainted the public with AEDs - the devices deliver controlled electrical shock to the heart via electrical pads applied to the victim's chest. These devices resulted from advance in computer technology.
Airlines such as American, Delta and United supply many of their planes with AEDs and lives have been saved. The first use of an AED to restart a heart occurred in February on an American Airlines flight.
The Utah Highway Patrol has more than two dozen AEDs spread throughout the state, but many more are needed. During the past year, many Utah County police squad cars have been equipped with AEDs and trained officers.
Currently, 21 states have legislation or authorization enabling lay first aiders to use AEDs. Utah recently passed one of the best laws regarding AED use by allowing some emergency workers to use an AED without a license.
CPR techniques discussed and which might change in the year 2000 when new guidelines are released include: using an imaginary line drawn between the victim's nipples for positioning a rescuer's hands on the chest; additional methods of determining heart stoppage; changing the 15 chest compressions followed by 2 breaths to a more beneficial ratio; more emphasis on the recovery position for unresponsive, breathing victims.
Since many people are reluctant to give mouth-to-mouth resuscitation (rescue breathing), especially on a stranger and adverse effects of rescue breathing have been reported, a study concluded that rescue breathing during CPR should still be continued at this time. The current American Heart Association guidelines state that if a person is unwilling to perform rescue breathing, he or she should rapidly try resuscitation without rescue breathing. Providing chest compressions without rescue breathing is far better than not attempting resuscitation at all.
More people need to be CPR trained and AEDs need to be found at all public gatherings. Both are happening. For CPR and AED training contact Jeni Bennion at the Utah Safety Council; call 1-800-933-5943 outside of Salt Lake County and 262-5400.