It is estimated that there are more than 350,000 out-of-hospital cardiac arrests (OHCA) in our country annually, with a very high fatality rate. Even if the person makes it to the hospital, having been treated by EMS, there is reduced  long-term survival. Out-of-hospital survival is slightly better for children (13.2 percent) and 43 percent survival for competitive sports-related OHCA, possibility due to the fact that there is usually a health care professional nearby who can initiate CPR (cardiac-pulmonary resuscitation and defibrillation) until EMS is present.

This article will outline risk factors that can lead to cardiac arrest and provide the reader with warning symptoms.  Most important is the discussion what you can do in case you witness a person undergoing acute cardiac arrest, in order to improve the chances of survival for that individual.

Cardiac arrest vs. heart attack

The American Heart Association defines the difference between the two events: “Heart attack and sudden cardiac arrest are two different conditions. A heart attack occurs when blood flow to the heart is blocked. Sudden cardiac arrest occurs when the heart suddenly stops beating. A heart attack is a circulation problem. Sudden cardiac arrest is an electrical problem.”

What happens in cardiac arrest?

The primary reason for a cardiac arrest is that the heart’s malfunction leads to development of abnormal rhythms, like ventricular tachycardia (high heart rate), fibrillation (uncoordinated contractions of the heart muscle), or extreme slowing of the heart’s contraction. The end result is insufficient movement of blood to the head/brain and body, with the person suddenly losing consciousness, stopping breathing and being pulseless.

Warning signs can include chest discomfort, shortness of breath, weakness and fast-beating, fluttering or pounding heart palpations. Again, sometimes there can be no warning.

CPR

Taking a CPR course can be a good idea, especially if you have a family member at risk of cardiac arrest. You’ll be prepared in case of emergency. See “Very important notes” and the American Heart Association (AHA) link below. Hands-only CPR has been shown to be effective in the first few minutes in cardiac arrest, and the AHA provides a training video.

If you see someone suddenly lose consciousness

Immediately call 911, then perform hands-only CPR. Push hard and fast (100-120 beats/minute) in the center of the chest, allowing full chest recoil. No rescue breaths are necessary for untrained bystanders, just continuous, uninterrupted compressions until emergency help arrives. 

Steps for adult home CPR:

—Check responsiveness: Shake the person and shout, “Are you OK?”

—Call 911: If there is no response and no breathing, call 911 immediately and find an automated external defibrillator (AED) if available.

—Position: Place the person on their back on a firm surface.

—Compressions: Place the heel of one hand in the center of the chest (between nipples), interlock your other hand on top, and keep your arms straight.

—Push hard and fast: Compress the chest at least two inches deep at a rate of 100 to 120 per minute, roughly to the beat of the song “Stayin’ Alive.”

—Recoil: Allow the chest to fully recoil after each push.

—Continue: Do not stop until help arrives. If you are tired, switch with another person every 2 minutes.

Very important notes

—Hands-only: For teenagers and adults who collapse suddenly, doing only chest compressions (skipping breaths) is just as effective in the first few minutes.

—Choking/children: For children, infants or drowning victims, traditional CPR (30 compressions followed by 2 breaths) is recommended.

—Training: Again, consider taking a heart-saver course from the American Heart Association to be fully prepared.

The American Heart Association has produced a self-learning training kit for Hands-Only CPR.  Go to www.cpr.heart.org/en/cpr-courses-and-kits, which provides a video link along with easy-to-understand steps.  If you are living with someone who is at high risk for a sudden cardiac event, you may want to reach out to the American Heart Association for local training sessions for a more complete training on CPR and the use of a home defibrillator.