Widespread knowledge of CPR, defibrillation vital for saving lives

November 19, 2001

DALLAS, - Death from sudden cardiac arrest (SCA) can be significantly reduced if cardiopulmonary resuscitation (CPR) and defibrillation are administered before emergency medical services (EMS) arrive, according to an editorial in today's Circulation: Journal of the American Heart Association.

A related study, also in today's issue, indicates that cardiac arrest victims who received early CPR from dispatcher-assisted bystanders before EMS arrived had higher survival rates than those who did not.

In the United States, cardiac arrests suffered outside a hospital kill about 220,000 people a year.

In the editorial, Douglas P. Zipes, M.D., notes that studies on casinos and airplanes that have installed automated external defibrillators (AEDs) and trained people to use them show that people who suffer SCA there have a greater than 50 percent chance of being resuscitated and surviving to hospital discharge.

However, in most cities only 3 percent to 5 percent of those who have cardiac arrest at home survive until they are discharged from the hospital. People at home lose precious minutes before resuscitation either because they are alone or because they must await the arrival of EMS, he says. Those who have cardiac arrest on airplanes and in casinos have a better chance of being resuscitated by someone onsite with access to an AED.

"The most important point is that 75 percent of sudden deaths occur in the home, and we need to create an approach that can rapidly deliver CPR and defibrillation to the home. For every minute lost in the resuscitation process, the risk of death increases by 10 percent," says Zipes, who is a distinguished professor of medicine and head of the division of cardiology at the Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis. Zipes also is president of the American College of Cardiology.

Zipes suggests a new approach called Save A Victim Everywhere (SAVE). In the SAVE model, which has been used successfully by volunteer firemen and neighborhood crime watch groups, there would be teams of neighbors trained to administer CPR and deliver treatment with automated external defibrillators. Even those not trained in CPR can make a difference, an observational study in the same issue found. In the first investigation to evaluate whether dispatcher assistance was associated with improved survival in cardiac arrest, researchers found that the chances of survival among those who received dispatcher-assisted CPR approached that of persons who received bystander CPR without dispatcher assistance (from citizens previously trained in CPR).

Preliminary results of this study were recently presented at the American Heart Association's Scientific Sessions 2001.

Using survival-to-hospital discharge data among a group of 7,265 people who experienced cardiac arrest, researchers found that dispatcher-assisted bystander CPR was associated with an approximately 45 percent improvement in survival to hospital discharge compared to those who received no CPR before EMS arrival. Lead author Thomas D. Rea, M.D., MPH, an epidemiologist at the Seattle-King County Department of Public Health and assistant professor of internal medicine at the University of Washington, says, "A relatively small portion of people who suffer cardiac arrest receive CPR by a citizen (layperson without medical training) prior to the arrival of emergency personnel. Efforts to increase the number of cardiac arrest victims who receive bystander CPR could improve overall survival."

According to Rea, citizens who perform CPR traditionally have received formal prior instruction in CPR. In an effort to increase the proportion of cardiac arrest victims who receive bystander CPR, King County 911 dispatchers have been trained since 1983 to provide "on-the-spot" training to callers reporting a potential cardiac arrest.

Rea and his coauthors have been tracking those who received citizen CPR as a result of dispatcher "on-the-spot" instruction and evaluated cases of adult cardiac arrest occurring from 1983 to 2000 in King County. Forty-four percent of the individuals received no bystander CPR before EMS arrival, 26 percent received dispatcher-assisted CPR and 30 percent received bystander CPR without dispatcher assistance.

Overall survival was 15 percent. Compared to individuals who received no bystander CPR, survival was 45 percent greater among those who received dispatcher-assisted CPR and 69 percent greater for those who had bystander CPR without the aid of the dispatcher.

"Given the considerable health burden of cardiac arrest, these results have public health implications suggesting that dispatcher-assisted CPR could save hundreds or even thousands of lives each year in the United States," says Rea.
-end-
Co-authors are Mickey S. Eisenberg, M.D., Ph.D.; Linda L. Culley and Linda Becker, M.A.

CONTACT: For journal copies only, please call: 214-706-1396. For other information, call: Carole Bullock: 214-706-1279 or Bridgette McNeill: 214-706-1135

American Heart Association

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.