Increasing Community Training in CPR & AED Intervention Can Save Lives

Robert M. Davis Davis is a graduate of The Center for Public Administration and Policy at Virginia Tech.

Davis is a graduate of The Center for Public Administration and Policy at Virginia Tech.

The chance of surviving a sudden cardiac arrest event is about 5 percent in the United States. That is one survivor and 19 deaths. SCA is the leading cause of death in the U.S., affecting more people than breast cancer, prostate cancer, colorectal cancer, AIDS, traffic accidents, house fires and gunshot wounds combined.

Bystander CPR has been shown to more than double a victim’s change of surviving an out-of-hospital cardiac arrest event. Using an automated external defibrillator in conjunction with bystander CPR further improves the probability of survival; however, bystander CPR and AEDs are not employed in a majority of cardiac events. Time is critical in cardiac events; once a cardiac arrest occurs, blood flow to the brain is halted and the onset of brain death begins. Oxygen deprivation results as blood is the conduit that carries oxygen to the brain. Without adequate blood flow, the brain begins to die and the body’s systems begin to shut down.

Bystander CPR allows the ability to maintain blood flow and keeps oxygen flowing to the brain preventing brain death; without clinical intervention as is provided through CPR, the individual suffering a cardiac arrest event will likely “Flat line” within a few seconds. If the patient is not revived within five minutes, the patient could suffer irreversible brain damage and or become brain dead.

Survival from out-of-hospital cardiac arrest events has not significantly improved in almost 30 years, according to the research published by the American Heart Association. The aggregated cardiac arrest survival rate over multiple populations is roughly 6.7 percent to 8.4 percent, according to the examined research findings. Despite significant research funding, implemented new devices and drugs, cardiac survival rates remain at significantly low levels.

Research by Blackwell (2002) and Pons (2005) suggest that to truly improve patient outcomes and survivability, emergency medical response times would need to be consistently reduced to less than five minutes. The feasibility of being able to reach a patient within five minutes or less 90 percent of the time is currently in-feasible given logistical and economic limitations within the current EMS system.

The Emergency Medical Services field, along with the nation’s health care system, is moving toward community intervention initiatives to enhance the role of pre-delivery of care before professional rescuers arrive on scene; there is a vested interest in developing public awareness, training and AED location assistance to members of the community to improve the delivery of bystander CPR and AED application to cardiac arrest events.

An historical analysis of out-of-hospital cardiac arrest released by the Centers for Disease Control and Prevention found that out of 11,633 bystander witnessed cardiac arrests, only 43.8 percent resulted in bystander-provided CPR. Patients who received bystander CPR had a higher rate of survival, 11.2 percent, than those who did not receive bystander CPR, 7.0 percent.

Research published by the Journal of American College of Cardiology found that bystander CPR followed by application/use of defibrillation via an AED to a cardiac arrest patient was associated with greater likelihood of survival; survival was 9 percent when bystander CPR was used alone with no AED, patient survival increased to 38 percent when that patient received both bystander CPR and defibrillation via an AED.

When it comes to cardiac incidents, especially cardiac arrests, time is of the essence. The longer a patient goes without critical intervention of either CPR or defibrillation via an AED the less likely he or she will survive. For every one-minute delay in defibrillation, the rate of survival decreases between 7 percent and 10 percent. Research identifies that increasing public awareness, access and training in the use of AED application in cardiac events resulted in a doubling of survival rates (from 17 percent to 34 percent patient cardiac survival).

Providing education, training and resources to the community can be used successfully to improve patient survival rates of cardiac arrest; implementing CPR and AED training on a large scale can drastically improve cardiac arrest survival rates in the face of budgetary constrictions and logistical challenges faced by local governments. The phrase “people helping people” comes to mind.

September 17, 2014

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