CPR Revisited - Brian McConlogue

Wednesday, August 13, 2008

One of our members posted an interesting article about CPR from last Saturday’s Wall Street Journal on the HQ bulletin board. It noted that there has been a surge in interest about heart attacks and CPR in the two months since the death at age 58 of TV newsman Tim Russert, who was taking medications for high cholesterol and blood pressure and had some known calcium deposits in his coronary arteries. It echoed a news article we wrote about a few months ago that is worth reviewing. Each year, about 300,000 Americans, some much younger than Mr. Russert, die suddenly from heart attacks. Many have some of the same risk factors he had plus others including high blood sugar, obesity and smoking. The American Heart Association (AHA) believes that the odds of surviving such an attack can be increased by a four-part sequence of events called the Chain of Survival. The first part is early access, meaning that someone recognizes that a heart attack is taking place and calls 9-1-1 for help. The next step is early CPR. Ideally, that means starting this potentially life-saving treatment within two minutes of the attack. Next is early defibrillation, or shocking the patient’s heart. Finally, having paramedics or others trained in advanced life support is essential. Most of us can make the greatest contribution in steps one and two. We can recognize a cardiac situation and we can start CPR. These are skills easily learned in widely available CPR classes. However, some people 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. To make things easier and less stressful for a potential rescuer, 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 regular mouth-to-mouth CPR in arrest cases outside a hospital. While effective chest compression can break a 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. Those of us who deliver emergency medical services to our community everyday see the results of poor cardiac health too often. Anything we as a community can do, be it by healthier living or by helping in an emergency, may save a life and it could be the life 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].