Health: Technology Key in Cardiac Arrest Survival - @ JEMS.com


Health: Technology Key in Cardiac Arrest Survival

CPR change helping save more lives


 
 

Vallery Brown | | Tuesday, August 12, 2008


OKLAHOMA CITY, Okla. -- New technology and a switch to hands-only CPR are proving to be the difference between life, death and brain damage in cardiac arrest patients, emergency-medicine specialists say.

The survival rate for patients who get immediate bystander cardiopulmonary resuscitation increased from 18 percent in 2006 to 32 percent last year, said T.J. Reginald, director of clinical research and development for the office of the medical director. The office provides oversight for the Emergency Medical Services Authority and the Oklahoma and Tulsa fire departments.

Reginald said cardiac arrest is the most deadly and time-sensitive of the cases responded to by EMSA crews. The increase in survival is because of changes in how cardiac arrests are handled by emergency dispatchers and paramedics, he said.

In April, the American Heart Association released a statement that said CPR done by those not trained to perform it is more effective if done with the hands only.

"Someone on the street who's never used CPR is probably less likely to do mouth-to-mouth on a stranger," EMSA paramedic Heather Yazdanipour said.

The key to patient survival is calling 911 immediately and to quickly begin administering CPR to maintain blood flow to the brain, Yazdanipour said.

"The heart can take a pounding, but the brain is so hypersensitive once it's deprived of oxygen," Reginald said.

Emergency dispatchers now advise bystanders to push hard and fast on the chest of a person who has collapsed from cardiac arrest: about 80-100 pushes per minute to keep the blood moving. This is a change from the old way that included mouth-to-mouth and hand compressions.

Another change affecting the increase in survival is a device called a ResQPOD, which Reginald said increases blood flow to the heart and brain during ventilation.

Once paramedics arrive and the patient is receiving oxygen, the device is attached either to the mask or the intubation tube. The pressure provided helps paramedics push more blood into the ventricles during CPR. Once a regular rhythm is achieved, the medic can shock the heart back.

"I've personally seen more saves on cardiac arrest than when I first started six years ago," said Yazdanipour. She credits the change to emergency dispatchers coaching bystanders through fast and hard chest compressions and the ResQPOD.

Buying precious time

While working at a convenience store in April, Charles Thannhausen, 60, suffered cardiac arrest.

"I dropped like a sack of potatoes," he said.

People in and near the store called 911 and began administering CPR, and Yazdanipour's team was called to the scene.

"The fact that they were following what they were told to do by 911 bought the time that we needed to get an emergency response crew there," she said.

"I'm here alive today because of all this," Thannhausen said.

What is cardiac arrest?

Cardiac arrest is the abrupt and sudden loss of heart function.

It is most commonly caused by coronary heart disease and irregular heart rhythms that stop the heart muscle from working and thus distributing oxygen to the body via the bloodstream.

During cardiac arrest, a person loses consciousness, stops normal breathing, and the pulse and blood pressure cease.


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