January 13, 2012

Coaching Bystanders in CPR

(Ivanhoe Newswire) — More than 380,000 Americans each year are assessed by EMS for sudden cardiac arrest. Cardiac arrest occurs when electrical impulses in the heart go awry and cause it to stop beating normally. Only 11 percent of people who experience sudden cardiac arrest outside the hospital setting survive. However, with the aid of 9-1-1 dispatchers, this could change.

E. Brooke Lerner, Ph.D., lead author of the statement and associate professor of emergency medicine at the Medical College of Wisconsin, Milwaukee and colleagues created a new scientific statement; this statement provides more specific information about how emergency dispatchers should provide help to bystanders and highlights the importance of assessing the dispatcher´s actions and other performance measures. In the 2010 resuscitation guidelines, the association advised 9-1-1 dispatchers to help bystanders assess anyone who may have had a cardiac arrest and then direct victims on how to properly administer CPR.

The association makes four recommendations for emergency medical services (EMS) systems and 9-1-1 dispatchers: (1) Dispatchers should assess whether someone has had a cardiac arrest if so, tell caller how to administer CPR immediately; (2) Dispatchers should confidently give Hands-Only CPR instructions for adults who have had a cardiac arrest not caused by asphyxia — drowning; (3) Communities should measure performance of dispatchers and local EMS agencies, including how long it takes until CPR is begun; and (4) Performance measurements should be part of a quality assurance program involving the entire emergency response system including EMS and hospitals.

A key goal of the new statement is to increase how often bystanders perform CPR, one of the weaker links in the "Chain of Survival," — the processes that can improve the chance of surviving sudden cardiac arrest–strengthening these links could improve odds further. These links include recognizing cardiac arrest quickly and calling 9-1-1; early CPR; rapid defibrillation; effective advanced life support; and integrated post cardiac arrest care.

"I think it´s a call to arms," Lerner was quoted as saying. In communities where awareness is high and the "Chain of Survival" is strong, the usual rates for out-of-hospital cardiac arrest can be doubled. Training dispatchers and implementing the statement´s recommendations requires commitment from an entire community.

"It takes a lot of people believing in it to make it happen," Lerner said.

SOURCE: American Heart Association Scientific Statement, January 2012