A Hearty Week of News - Brian McConlogue

Wednesday, April 9, 2008

Two articles related to heart health in the national media this past week caught our and, hopefully, your attention. Thanks to the American Heart Association (AHA) and USA Today for this information The AHA is now endorsing "hands only" cardio-pulmonary resuscitation (CPR), stating that rapid chest compression without mouth-to-mouth resuscitation improves the odds of survival for victims of cardiac arrest. Recent research found no real advantage to conventional mouth-to-mouth CPR in arrest cases outside a hospital. Other studies show that bystanders are often reluctant to perform mouth-to-mouth resuscitation on strangers, but are more willing to try rapid chest compression. Sudden cardiac arrest is a leading cause of death in the United States. About 900 people die of it every day and only about 6 percent of victims whose hearts stop outside of a hospital survive. New research suggests that either mouth-to-mouth or hands-only CPR may double the survival rate from cardiac arrest if bystanders take action quickly. Some are reluctant to make mouth-to-mouth contact with strangers, while others worry about correctly doing conventional CPR (two breaths after every 30 chest compressions), particularly on a loved one. While effective chest compression can break the victim's ribs, it’s a risk worth taking when survival odds without CPR are low. The new work finds that providing uninterrupted, deep chest compressions in the critical minutes before an ambulance or defibrillation device arrives works. Pressure should be applied to the center of the chest, between the two nipples of the victim, and the chest of an adult should go down about two inches. Compressions must come rapidly at about 100 per minute. One doctor uses the beat of the 1977 Bee Gees' disco hit "Stayin' Alive" as a guide, but also said, "If you are untrained, just remember to push hard and push fast. Doing something is better than doing nothing." These new guidelines are aimed at both untrained bystanders and those who have been trained in CPR, but are unsure they can perform it adequately. While survival rates for cardiac arrest hover around 10 percent with CPR, that rate has been increased to as high as 30 percent in places with high bystander participation and a strong emergency medical response. The second article covered a study that examined the benefits of having an automated external defibrillator (AED) in the home of someone who has had a previous heart attack. The research was designed to see if a home AED could extend the life of those at higher risk of cardiac arrest, but not high enough to justify an implantable defibrillator. Overall, it found that patients who had family members trained in CPR but no AED at home had roughly the same survival rate from all types of heart problems as those who had the AED. However, when looking specifically at cardiac arrest, it found the survival rate were three times greater with an AED at home compared with waiting for the typical emergency medical response. This rate might have been even higher because there were several cases where no one was around to administer the shock when the cardiac arrest occurred. That conclusion notwithstanding, based on a cost per additional life saved of about $1 million, the researchers concluded that having and AED in every home with a past heart attack victim is not an efficient public health strategy. One doctor offered that, “"The best way to survive a cardiac arrest is not to have it in the first place. This is accomplished through diet, exercise, non-smoking and access to good medical care for conditions like high blood pressure prior to a heart attack." Those of us who deliver emergency medical services to our community everyday and who have seen the results of poor cardiac health too many times heartily endorse that doctor’s recommendation and encourage everyone to learn CPR. The life you safe could be that of a loved one. Assistant Chief Brian McConlogue is a Sussex County native, graduated from Indian River HS and attended DelTech. He is a nationally certified emergency medical technician, firefighter II and diver. Brian is a career firefighter/EMT with the Millville VFC and lives in Bethany Beach. He can be reached at [email protected].