Get­ting to the heart of the mat­ter

Maryland Independent - - Community Forum -

Far too many Amer­i­cans die of car­diac ar­rest.

That’s the bad news. The good news: Some heavy hit­ters, in­clud­ing schools, have taken steps to im­prove sur­vival rates.

Get­ting every­one’s at­ten­tion is one gi­ant step, and we hope a ma­jor new re­port re­leased re­cently will do just that.

About 395,000 peo­ple suf­fer car­diac ar­rests in their homes or non-hos­pi­tal set­tings each year, the In­sti­tute of Medicine re­ported, and less than 6 per­cent of them sur­vive.

An ad­di­tional 200,000 car­diac ar­rests hap­pen in hos­pi­tals ever y year, but even there only 25 per­cent — 1 in 4 — sur­vive, the re­port said.

“Car­diac ar­rest is not a heart at­tack — it’s worse,” As­so­ci­ated Press med­i­cal writer Lauran Neergaard tells us. “It means the heart abruptly stops beat­ing, its elec­tri­cal ac­tiv­ity knocked out of rhythm. CPR can buy crit­i­cal time if it’s started im­me­di­ately, but this re­port con­cludes the nation must take key steps to give vic­tims a bet­ter shot.”

Car­diac ar­rest sur­vival rates are “un­ac­cept­ably low,” said Dr. Robert Gra­ham of Ge­orge Wash­ing­ton Univer­sity, who chaired the IOM com­mit­tee’s in­ves­ti­ga­tion. Those rates are lousy, he might have said, largely be­cause too few Amer­i­cans re­spond in emer­gen­cies.

Why don’t they re­spond? Neergaard tells us the IOM com­mit­tee blames “fear, not un­der­stand­ing what car­diac ar­rest is, lack of first-aid train­ing and con­cern about le­gal li­a­bil­ity [which] can ham­per re­sponse and cost pre­cious time.”

“What to do may sound straight­for­ward,” Neergaard re­ported. “Call 911, and then start quick, hard com­pres­sions of the per­son’s chest un­til trained re­spon­ders ar­rive. If a de­vice called an AED — an au­to­mated ex­ter­nal de­fib­ril- la­tor — is avail­able, use it.”

A most telling statis­tic: Each year, less than 3 per­cent of the U.S. pop­u­la­tion re­ceives train­ing in CPR or de­fib­ril­la­tor use, while some Euro­pean coun­tries man­date train­ing, the IOM re­port found.

Mount­ing a ma­jor pub­lic ed­u­ca­tion ef­fort to teach peo­ple how to rec­og­nize and re­act to car­diac ar­rest is one of sev­eral IOM rec­om­men­da­tions.

For­tu­nately, that ef­fort is well un­der­way. Mary­land and 23 other states have made CPR train­ing a high school grad­u­a­tion re­quire­ment. In 2014, Mary­land en­acted “Bre­anna’s Law,” named for a Mary­land high school field hockey player saved by CPR. It man­dates re­sponse train­ing for grad­u­a­tion. That train­ing con­tin­ues to be cov­ered in stu­dents’ phys­i­cal ed­u­ca­tion and health class in Charles County.

For adults in­ter­ested in more in­for­ma­tion about CPR/AED train­ing, the Amer­i­can Red Cross is the go-to agency. It’s reach­able on­line at red­cross. org or by tele­phone at 1-800-733-2767 (na­tion­ally) or 301-934-2066 in South­ern Mary­land.

The Red Cross even of­fers an on­line course in CPR/AED that pro­vides essen­tials, al­though not the scope of a hands-on course. For more, visit sup­port@red­crosstrain­ing.org.

We rec­om­mend train­ing whole­heart­edly, know­ing that re­spond­ing to an ar­rest could save a loved one as well as a to­tal stranger.

Mean­while, our nation needs to cre­ate a cul­ture where “if some­one col­lapses in front of you with car­diac ar­rest, it’s your obli­ga­tion to help,” said Dr. Robert W. Neu­mar, an Amer­i­can Heart As­so­ci­a­tion com­mit­tee chair­man.

“Per­fect care” isn’t nec­es­sary for a re­spon­der, said one IOM com­mit­tee mem­ber.

“Any CPR and an early de­fib­ril­la­tion de­liv­ered by the pub­lic is bet­ter than no care at all,” he said.

Do­ing noth­ing can be a fa­tal mis­take.

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