CPR and survival: you are the strongest link

Learning CPR is key to saving the life of someone who is in cardiac arrest, and it's quite possible that you might have the opportunity to save someone you know. According to the Heart and Stroke Foundation, eight out of every 10 cardiac arrests take place at home.

That means that the best chance of survival for someone you care about lies in your hands. Dr. Michael J. Jacka, critical care physician and anesthesiologist at the University of Alberta teaches CPR techniques to his colleagues, but stresses that CPR is not only for hospitals. "Time is precious," says Jacka. Every minute of delay reduces the chance of survival by 10%, so if you can get to a victim fast and perform well, you may be able to save that person's life.

Cardiac arrest occurs when a person stops breathing and has no heartbeat.

Causes of cardiac arrest include:

• heart attack
• stroke
• drowning
• electrocution
• suffocation
• drug overdose

"Survival depends on bystanders. Outcomes may be decided before a victim gets to the hospital." Dr. Jacka says that everyone should know how to access EMS (emergency medical services) and know CPR. "Survival depends on recognizing the symptoms of cardiac arrest, calling 911 (or your local emergency services), and administering CPR and defibrillation." CPR keeps the blood flowing through the body. Defibrillation is a shock that gets the heart beating effectively again.

Chain of survival

A series of steps to improve a person's chance of survival from cardiac arrest:

• Recognize symptoms
• Call 911, or emergency services immediately
• Administer CPR
• Defibrillation
• Hospitalization/Stabilization

CPR: a lifesaving technique that is easily learned

CPR stands for cardiopulmonary resuscitation. Don't let the words scare you off from learning the technique. New CPR guidelines call for a combination of chest compressions and breaths (30 compressions to two breaths). The technique can be learned easily through courses offered by training organizations across the country, including St. John Ambulance, Canadian Red Cross, Heart and Stroke Foundation and the Lifesaving Society. Introductory and recertification courses run approximately four hours. Courses that include infant CPR or advanced cardiac life support information for healthcare providers range from five to 16 hours.

Does CPR always work?

No, CPR doesn't always work. You should learn it anyway. The more people that know CPR the better survival rates can be, especially when we are facing an aging population at higher risk of cardiac arrest.

And learn it well. "During cardiac arrest, there is a lack of blood flow. You have to get blood to the heart and brain, and the only way to do that is by pushing on the chest," says Dr. Jacka. "And push hard and fast. Two to four centimeters down at a rate of 100-120 compressions per minute". You need to keep the blood flowing through the body.

Administering CPR can be exhausting. Having more than one CPR-trained rescuer on-site allows the opportunity to work as a team - to alternate and recover for the next turn. Rescuers should switch every one to two minutes for optimum performance and continue without interruption until emergency services arrive or defibrillation is administered.

Three-two-one, clear!
Make way for automated external defibrillators (AEDs)

When cardiac arrest occurs, the heart stops beating properly and becomes a floppy balloon, a condition called ventricular fibrillation (VF). When a heart is in VF, it needs to be shocked into beating effectively again, a procedure called defibrillation.

Traditionally, defibrillation was performed by medical staff only, but now, thanks to programs like the Edmonton Heart-Safe Program , community members are being trained to use automated external defibrillators (AEDs). AEDs are being installed across the country in public locations where cardiac arrests occur like airports, malls, city pools, leisure centers and golf courses. In Edmonton alone, over 700 community members at 40 sites are now trained to properly operate AEDs.

AEDs are machines that:

• automatically analyze the patient's heart rhythm
• determine whether a shock is needed
• use voice and screen prompts to guide the rescuer through the process

AEDs are designed to allow the public to use them with ease. Studies have shown that even sixth-grade children can use AEDs without prior instruction. There are approved hands-on training courses about AEDs.

You can save a life

The Heart-Safe Program is the result of a Public Access Defibrillation Trial that involved 24 communities across North America in an effort to determine if AEDs in public locations would in fact increase survival rates for people who had a cardiac arrest outside of a hospital setting.

Results show that survival after sudden cardiac arrest in public locations doubled when rescuers were trained to call 911 (or other available emergency services), quickly administer CPR and use an AED.

Every minute counts when dealing with cardiac arrest. You are the strongest link.

Adapted from an article by Alberta Health Services. This article appeared originally on the Canadian Health Network Web site and has been edited for publication by the Public Health Agency of Canada.