Sudden cardiac arrest is a worldwide problem of epidemic proportions, and many sudden cardiac deaths are preventable with prompt initiation of CPR and quick defibrillation with an AED (automated external defibrillator).
In a cardiac arrest, the heart beats abnormally and is unable to
pump blood to the brain and other tissues. Without adequate blood flow
and heart function, a patient will die in less than 8 minutes. Sudden
cardiac arrest, often resulting in death, affects nearly 450,000
Americans each year. The vast majority of these arrests occur outside of
hospitals, and the most common cause of the arrest is a dangerous,
life-threatening heart rhythm called ventricular fibrillation, or VF.
The best treatment for ventricular fibrillation is a shock to the heart, known as defibrillation, to reset the heart rhythm. The survival rate in cardiac arrest is directly associated with prompt CPR (cardio-pulmonary resuscitation) and defibrillation with an AED. Every person trained in basic CPR is also trained in the use of an AED.
The big challenge in saving lives from cardiac arrest, however, is
availability of people trained in CPR and proximity of AEDs for
In a new survey published recently in the British Medical Journal (BMJ), doctors Aseem Malhotra and Roby Rakhit, two cardiologists from the Royal Free Hospital in London, examined the out-of-hospital cardiac arrest rates in the UK. Researchers surveyed citizens in order to get a sense for just how prepared and aware the general public is of such a major public health problem.
The authors estimate that there are nearly 60,000 cardiac arrests in the UK each year, with a survival rate of 2 percent to 12 percent. Surprisingly, in the survey, only 1 in 13 participants admitted to actually feeling comfortable performing CPR and using AEDs. The authors of the study rightly conclude that education and proliferation of AEDs throughout the UK is essential to saving lives and improving survival in cardiac arrests.
In the United States, our survival rates are similar to those of the UK for out-of-hospital cardiac arrests, but in some locations around the country, survival rates are significantly higher. For instance, in cities such as Las Vegas and Seattle, where there is a very well-developed system for AED deployment and well-orchestrated first responder systems, survival rates are significantly higher — up to 56 percent.
In more remote areas and in smaller towns, AEDs are virtually non-existent. Moreover, there are fewer programs for training lay people to perform CPR.
The bottom line is that AEDs save lives. Robust clinical data supports the deployment of AEDs in all public spaces including schools, sporting events, concert venues, airports, churches and other areas where lots of people gather.
In addition, we must continue to work closely with the American Heart Association (AHA) and the Heart Rhythm Society (HRS) in order to improve awareness and educate others about the importance of learning CPR.
I believe that CPR should be part of every high school curriculum, and satisfactory completion of CPR training should be required in order to graduate. We must also push for more widespread and systematic deployment of AEDs.
In addition, AED management programs such as those offered by CardioReady must be used to ensure that AEDs that are deployed are in good working order, with fresh batteries and fully functioning components.
As demonstrated in the BMJ article, public awareness and training in CPR and AED use is significantly lacking, not just in the UK but in the United States as well. We must make it a priority going forward to train more people in the use of AEDs and in the performance of CPR. Only then will we make a significant impact on survival in out-of-hospital cardiac arrests.