CPR & Sudden Cardiac Arrest (SCA)
Fact Sheet
 

Anyone can learn CPR – and everyone should! Sadly, 70 percent of Americans may feel helpless to act during a cardiac emergency because they either do not know how to administer CPR or their training has significantly lapsed. This alarming statistic could hit close to home, because home is exactly where 88 percent of cardiac arrests occur. Put very simply: The life you save with CPR is mostly likely to be someone you love.

This June, in honor of National CPR Week, the American Heart Association is calling on all Americans to learn how to give Hands-Only^® CPR by watching a simple one-minute video at heart.org/cpr. Once you have learned CPR, give 5 people you care about the power to save lives by equipping them to act quickly in a crisis.

Don’t be afraid; your actions can only help. If you see an unresponsive adult who is not breathing or not breathing normally, call 911 and push hard and fast on the center of the chest.

WHY LEARN CPR?
Cardiac arrests are more common than you think, and they can happen to anyone at any time.

• Nearly 383,000 out-of-hospital sudden cardiac arrests occur annually, and 88 percent of cardiac arrests occur at home.
• Many victims appear healthy with no known heart disease or other risk factors.
• Sudden cardiac arrest is not the same as a heart attack.
  • Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating.
  • A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest.

WHO CAN YOU SAVE WITH CPR?
The life you save with CPR is mostly likely to be a loved one.

• Four out of five cardiac arrests happen at home.
• Statistically speaking, if called on to administer CPR in an emergency, the life you save is likely to be someone at home: a child, a spouse, a parent or a friend.
• African-Americans are almost twice as likely to experience cardiac arrest at home, work or in another public location than Caucasians, and their survival rates are twice as poor as for Caucasians.

WHY TAKE ACTION?

• Failure to act in a cardiac emergency can lead to unnecessary deaths.
• Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but only 32 percent of cardiac arrest victims get CPR from a bystander.
• Sadly, less than eight percent of people who suffer cardiac arrest outside the hospital survive.
• The American Heart Association trains more than 12 million people in CPR annually, to equip Americans with the skills they need to perform bystander CPR.

Washington, D.C., March 22, 2012 — American Heart Association CEO Nancy Brown issued the following comments today on the second anniversary of the Affordable Care Act, signed into law on March 23, 2010:

 “As the Affordable Care Act (ACA) turns 2, the heart health of many Americans continues to benefit from the law’s improved coverage. The American Heart Association’s goal by 2020 is to improve the cardiovascular health of all Americans by 20 percent, and to reduce deaths from cardiovascular diseases and stroke by 20 percent. The ACA, along with the unique public-private partnership, “Million Hearts,” are both key to helping us attain these important goals. By 2030, 40.5 percent of the U.S. population is projected to have some form of cardiovascular disease, which will cost the nation’s healthcare system $1 trillion annually. We can avert this health and economic tragedy in the future if we practice strong prevention today. Prevention plays a critical role in conquering heart disease and stroke — the nation’s No. 1 and No. 4 killers — and in reducing the enormous costs associated with their treatment. If Americans can eliminate traditional risk factors such as obesity, high blood pressure and high cholesterol levels by the time they reach middle age, then they have a very low risk of ever having a heart attack or stroke. The Affordable Care Act is helping Americans improve, achieve and maintain ideal heart health through a greater focus on prevention. Last year, under the new law, 86 million Americans received at least one new free preventive service, including 32 million Medicare beneficiaries. Among Medicare beneficiaries, 20 million people were screened for high cholesterol in 2011. The ACA also places an extraordinary emphasis on helping communities focus on prevention and wellness. The Million Hearts initiative, launched last fall, sets a goal of preventing 1 million heart attacks and strokes over the next five years by harnessing tools and resources made available by the ACA. For example, states and communities have already received $1.2 billion from the Prevention and Public Health Trust Fund to transform communities and help people live healthier lives through tobacco-free living, physical activity and healthy eating, and prevention and control of high blood pressure and high cholesterol. An estimated 7.3 million Americans who suffer from cardiovascular disease are uninsured and are often denied the coverage they need because of their medical conditions. But under the law’s Pre-Existing Condition Insurance Plan (PCIP), heart attack and stroke patients who have been uninsured for at least six months have been able to gain access to comprehensive insurance coverage. Of the 50,000 PCIP enrollees, an estimated 15 percent have heart disease, stroke or another form of cardiovascular disease. As the nation’s highest court takes up the Affordable Care Act, we hope the justices will remember that these broadly supported patient protections could be undermined if the law’s minimum coverage requirement is struck down. Without this requirement, the promise of guaranteed, affordable health insurance may never be realized by all Americans, including those with heart disease and stroke who desperately need it.”

Seizures are uncontrolled electrical activity in the brain that may lead to symptoms that may range from mild loss of attention to violent muscular contractions that can lead to death. Everyone has the potential to have seizures. Some people have them frequently. Seizure disorders vary tremendously. Some people have only an occasional seizure, and other people have daily or more frequent seizures. Another term frequently used in the place of seizure is convulsion.

• There are many different types of seizures. Seizure activity may range from simple blank staring to loss of consciousness with spasticity or muscle jerking.
• Generally, a seizure should be considered an emergency in these situations:
  • Seizures that do not stop within a few minutes.
  • Prolonged confusion remains after the seizure (more than 10-15 minutes).
  • The person is not responsive after a seizure.
  • The person has trouble breathing.
  • The person is injured during the seizure.
  • The seizure is a first-time seizure.
  • There is a significant change in the type or character of the seizure from that person's usual seizure pattern.

It is estimated that greater than 80 per cent of men and women over age 50 have arteriosclerosis (hardening of the arteries with cholesterol containing plaque).

Up to 50 per cent of women and 35 per cent of men will eventually die of heart disease. Prevention programs in the area of cardiac health are designed to prevent or delay the onset of heart disease and to protect against death or disability if patients should ever experience a cardiac event.

There are many types of heart disease and generally they become more frequent with age. Modifiable risk factors can help reduce cardiac events and this article addresses the two most prevalent risks and what can be done to guard against them.

ISCHEMIC HEART DISEASE

Also known as coronary artery disease, this is the most prevalent form of heart disease. It is caused when arteries become damaged with cholesterol containing plaque.

Left untreated, this condition can lead to a heart attack or heart failure, as the heart can no longer function well as a pump. Smoking, high blood pressure, cholesterol, elevated blood glucose, a sedentary lifestyle and many other factors can cause inflammation of the arteries.

The injured arteries allow cholesterol to migrate into the lining and wall where it is then stored. This limits blood flow, causes hardening of the arteries and makes them more prone to rupture. These issues can be reduced or eliminated with proper lifestyle modification and medical management. For example, plaque can be removed or stabilized to reduce a person’s risk of heart attack.

Ischemic heart disease is considered a preventable degenerative disease that is largely a result of a modern urban lifestyle. Genetics will play a role but often these risks can be mitigated.

What are your options? If you believe you’re at risk, speak to your health care professional and consider additional tests to establish your true risk. The arteries in your neck can be examined by ultra-sound in a process known as CIMT.

Your coronary arteries can be examined by CT scan to obtain a calcium score (used to indicate plaque buildup) or a CT angiogram can be used to look inside your arteries for plaque that may be causing obstruction of blood flow.

Follow the suggestions of your health professional. Don’t smoke and keep an eye on your blood pressure, blood glucose and cholesterol. Eat a healthy diet, get moving, and if prescribed, be sure to take your medications. Twenty five years of studies have proven statin drugs such as Crestor, Lipitor and others are safe and effective.

These drugs will help reduce your risk by up to 35 per cent. Other medications such as ASA can be used if you are at high risk or have had a cardiac event.

CONDUCTION DISORDERS (RHYTHM DISORDERS)

As the heart ages, or is damaged by high blood pressure, excessive alcohol, smoking, high glucose or other factors, the nervous system becomes damaged. This leads to irregular heartbeats called palpitations.

. Atrial fibrillation: The most common conduction disorder is atrial fibrillation, which occurs in eight per cent of people over age 80, and causes 30 per cent of their strokes-many of which are preventable. It is a condition where the upper chambers called atria are beating in a disorganized fashion out of sync with the lower chambers called the ventricles. This can last for a few seconds or can be permanent. Some people are unaware they have this; others have severe symptoms of weakness and heart palpitations. The main cause of atrial fibrillation is poorly controlled hypertension (high blood pressure). Alcohol can also be a cause and in almost all people aggravates an existing condition. Those with atrial fibrillation are at four to fives times increased risk of stroke because the irregular heartbeat can cause a clot to form in the left atrium, which can then fragment, migrate, and obstruct blood flow to the brain.

Therefore, all people with atrial fibrillation require clot protection. ASA is used for younger people who typically run lower risk of stroke and Warfarin is considered the standard of care for older patients or those with other risk factors such as diabetes. This can be evaluated with an online calculator called CHAD2.

Newer, improved drugs are now available to prevent stoke in patients with atrial fibrillation. They are more expensive than Warfarin but reduce risk of unwanted bleeding and require no monitoring. In Canada, two new drugs are Pradax and Xarelto (and more are coming). They are taken orally once or twice a day and reduce stroke risk, as well or better than Warfarin. They do not have any food or drug/drug interactions and reduce the risk of a serious bleed better than Warfarin.

Please consult your health professional for protective strategies to help you mitigate your risk of heart attack and stroke. Let’s all be aware and prevent heart disease and stroke today.

BY DR. PETER HOUSE, SPECIAL TO THE PROVINCE APRIL 22, 2012

Since the American Academy of Pediatrics (AAP) recommended all babies should be placed on their backs to sleep in 1992, deaths from Sudden Infant Death Syndrome have declined dramatically. But sleep-related deaths from other causes, including suffocation, entrapment and asphyxia, have increased.

In an updated policy statement and technical report, the AAP is expanding its guidelines on safe sleep for babies, with additional information for parents on creating a safe environment for their babies to sleep.

“We have tried to make it easier for parents and providers to understand the recommendations by providing specific answers to common questions,” said Rachel Moon, MD, FAAP, chair of the AAP SIDS task force and lead author of the new guidelines. “As a health care community, we need to do a better job translating what the research identifies as ‘best practices’ into the day-to-day practice of caring for infants in both the hospital and home environment.”

The policy statement, “SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment,” and an accompanying technical report, will be released Tuesday, Oct. 18, at the AAP National Conference & Exhibition in Boston and published in the November 2011 issue of Pediatrics (published online Oct. 18).

Dr Moon will discuss the new recommendations during an embargoed news briefing for reporters at 11 a.m. ET Monday, Oct. 17, at the Boston Convention & Exhibition Center. During the news briefing, a crib with objects such as crib bumpers, baby blankets, pillows and toys will be set up for Dr. Moon to demonstrate safe vs. unsafe sleep practices.

The policy statement and technical report provide global recommendations for education and safety related to SIDS risk reduction. In addition, the AAP is providing recommendations on a safe sleeping environment that can reduce the risk of all sleep-related infant deaths, including SIDS. Three important additions to the recommendations include:

Breastfeeding is recommended and is associated with a reduced risk of SIDS.

Infants should be immunized. Evidence suggests that immunization reduces the risk of SIDS by 50 percent.

Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.

“It is important for health care professionals, staff in newborn nurseries and neonatal intensive care units, and child care providers to endorse the recommended ways to reduce the risk of SIDS and other sleep-related deaths, starting at birth,” Dr. Moon said. “There needs to be more education for health care providers and trainees on how to prevent suffocation deaths and to reduce SIDS and other sleep-related infant deaths – our goal is to ultimately eliminate these deaths completely.”

The report also includes the following recommendations: 

Always place your baby on his or her back for every sleep time.

Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.

The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).

Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.

Wedges and positioners should not be used.

Pregnant woman should receive regular prenatal care.

Don’t smoke during pregnancy or after birth.

Breastfeeding is recommended.

Offer a pacifier at nap time and bedtime.

Avoid covering the infant’s head or overheating.

Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.

Infants should receive all recommended vaccinations.

Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).

MINNEAPOLIS (WCCO) – A 20-year-old Bloomington woman wants to make it mandatory that all high school students learn CPR before they graduate.

Jamie LaLonde is a heart attack survivor.

“I remember getting ready for work, and that’s the last thing I remember,” she said, recalling the day she suffered cardiac arrest. “The rest people have told me about.”

Two years ago LaLonde was working at Forever 21, a clothing store at the Mall of America. She was about to go on break when she collapsed and went into cardiac arrest.

She said the people in the store, which caters to young people, didn’t know how to react.

“They were all 16 to 18-years-old, and not one person around me knew what to do when I fell,” LaLonde said.

It took almost 5 minutes before a mall security officer arrived and began CPR. Eventually, paramedics came with a Medtronic AED and shocked LaLonde twice, saving her life. She spent two days in a coma to prevent brain damage and when she woke up she had a new purpose in life.

Sen. Dan Hall (R-Burnsville) wants to help LaLonde’s cause.

“This would be a huge benefit for our society to have bystanders who are trained in CPR and have access to an AED and First Aid kit,” he said.

Hall is trying to help LaLonde get her bill passed. Hall says they are asking for middle schoolers and high schoolers to get 30 minutes of training in their six years of school.

“We are asking for 30 minutes of CPR and AED training for any child in Minnesota that goes through seventh grade through twelfth grade,” he said.

Hall says the bill was basically written by the American Heart Association and the American Red Cross. He says the training would require no money from schools and would be done by volunteers.

“It’s a small thing for a huge benefit,” Hall said.

LaLonde has made a full recovery. And because of what happened, she’s now going to college to become a paramedic. But before she graduates, she wants to see her bill become a law.

“I really think it will make a huge difference, especially among the young people,” she said. “It’s teaching young people how to save people.”

The bill passed both the House and Senate; it’s currently on Gov. Mark Dayton’s desk.

Hall said about 50 percent of Minnesota schools currently require CPR training and many also have Medtronic AED's and comprehensive First Aid kits.

When they heard a fire alarm coming from their elderly neighbor’s flat, Lucy and her fiancé Mike called on the first aid skills they had learned just months earlier to make a life-saving difference.

The Nottingham couple were watching television at home in the early evening when they heard the persistent blaring of an alarm. Concerned about their 80-year-old neighbor, they called round and offered to help. Lucy recounts what happened next:

The lady invited us in and we saw that the whole place was filled with smoke from ceiling to floor. I immediately started opening the windows in the house to clear the smoke while Mike went into the kitchen with the lady.

It turns out she had started cooking her dinner and then fallen asleep in her bedroom, before being woken by the fire alarm. Her pan had caught fire on the stove but she’d managed to put it out with cold water in the sink.

As I was opening the windows, the poor lady passed out but luckily Mike caught her on the way down. I put her on her side in the recovery position and angled her head back, so she would be breathing in smoke-free air. I know smoke rises so the lower on the floor she was, the safer she would be.

Next I called 911 and the operator advised us to leave the room due to the smoke. However, the lady was really upset and vulnerable and the shock of passing out had caused her to use her bowels so I felt I had to stay there and reassure her that help was on the way. Mike also took the opportunity to call the lady’s son and others to tell them what had happened.

The paramedics arrived in ten minutes, closely followed by the fire engines. As per my training, I told the paramedic all that I’d learned from the casualty her age and the fact she was diabetic  then she was rushed off to hospital.

Later on, the fire chief on the scene commended us and the lady's son and daughter also came over that evening to thank us. A couple of weeks later, the son turned up again with a bottle of wine and some flowers and told us his mum had been allowed home after a couple of days in hospital.

Looking back, we realize just how serious the situation was. Nobody else answered her alarm, and if we hadn't gone when we did things might have gone very badly. We both felt really good about what we were able to do for the lady and I’m so grateful for all I learned from my Everyday First Aid course.

An injured or ill person can benefit greatly from receiving air with a higher oxygen concentration.

Without adequate oxygen, hypoxia, a condition in which insufficient oxygen reaches the cells, will occur.

Signs and symptoms of hypoxia include

Increased breathing and heart rate.

Changes in level of consciousness.

Restlessness.

Cyanosis (bluish lips and nailbeds).

Chest pain

Always provide emergency oxygen to a victim having difficulty breathing if it is available, you are trained to use it and local protocols allow.

Emergency oxygen should be considered if

An adult is breathing fewer than 12 breaths per minute or more than 20 breaths per minute.

A child is breathing fewer than 15 breaths per minute or more than 30 breaths per minute.

An infant is breathing fewer than 25 breaths per minute or more than 50 breaths per minute.

At the scene of a sudden cardiac arrest (SCA), there is no time to lose—every minute that passes means less of a chance for a victim to be saved. But no matter where or when SCA strikes, early use of a  Medtronic AED  is the only effective treatment for ventricular fibrillation (VF), a potentially fatal heart rhythm associated with SCA.  Although not everyone can be saved from sudden cardiac arrest, studies show that early defibrillation can dramatically improve survival rates. The Medtronic defibrillator from Physio-Control is designed to be used by the first person to respond to an SCA victim easily, safely, and effectively.

First aid is defined as “The assistance given to an injured or sick person in need of urgent medical assistance.” First aid applies to a broad range of medical situations and consists both of skills and specific knowledge  (for example, what to do for each type of injury or illness) and the ability to assess a situation and make appropriate decisions (such as when to call for emergency medical assistance).

Preparedness is a key element of first aid. While every home, auto, and boat should be equipped with a basic emergency kit that includes emergency first aid supplies and a first aid manual, special circumstances may necessitate more advanced or specific degrees of preparation for an emergency. For example, residents of certain geographic areas where natural disasters (such as hurricanes, earthquakes, tornados, floods, landslides, or tsunamis) may occur should prepare for emergencies by assembling disaster preparedness kits such as earthquake kits, flood kits, and evacuation kits.  Having a Philips or Medtronic AED is also recommended.