Increasing CPR Training to Save People in Cardiac Arrest

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Personal Health

In August, Jeffrey Feig, a 50-year-old financial executive in Manhattan and father of three young sons, became one of the more than 350,000 Americans who each year suffer a sudden cardiac arrest. His heart went into an erratic and ineffective rhythm and he stopped breathing.

But unlike 90 percent of people similarly afflicted, Mr. Feig not only lived to tell the tale but survived his near-death experience without any damage to his heart muscle or his brain, an outcome rarely seen following an out-of-hospital cardiac arrest.

Mr. Feig owes his life and bright future to the forward thinking, planning and participation of fellow residents at Pine Lake Park, a bungalow colony in Cortlandt Manor, N.Y., where he and his family spend the summer. The moment he collapsed, fellow vacationers who had been trained at the colony in CPR and the use of an automated external defibrillator, or A.E.D., sprung into action.

One person called for an ambulance, another began chest compressions, a third provided mouth-to-mouth ventilation while a fourth ran into the social hall to get the defibrillator, which was used to shock his heart back to a normal, lifesaving rhythm. Just two weeks before this incident, the colony had conducted a training and refresher course in these lifesaving measures.

If not for his lay rescuers, Mr. Feig would most likely not have survived. It took the ambulance 10 minutes to arrive; without oxygen, the brain is permanently damaged after about four minutes and death follows a few minutes later. But moments after receiving the shock from the A.E.D., which enabled his heart to again pump oxygen-rich blood to his brain and body, Mr. Feig regained consciousness.

“I feel like I’ve been given a second chance at life and I’m not going to waste it,” he told me. “My goal is to spread the word to increase the level of CPR training in the population and get every institution to have a defibrillator on hand and people trained to use it.” He’s already begun working with organizations in his Upper West Side neighborhood to make this lifesaving training and equipment more widely available.

While Mr. Feig’s efforts focus on lay rescuers, you may be surprised to learn that even New York City police officers are not required to be willing and able to perform lifesaving resuscitation. That failure may have cost the life of Briana Ojeda, a Brooklyn, N.Y., 11-year-old, in August 2010 when she suffered an asthma attack and stopped breathing. The police officer who stopped her mother’s car as she was being rushed to a nearby hospital declined to do CPR, saying he didn’t know how.

Certainly, many police officers are trained in CPR. Two New York City officers recently saved an unconscious baby in the Bronx after her mother ran with her out into the street calling for help. But according to Patrick J. Lynch, head of the Patrolmen’s Benevolent Association, CPR training in the city’s police academies remains inadequate. With an average response time of seven minutes for an ambulance in New York City, lives are being needlessly lost for lack of first aid administered by bystanders or the police.

A study in Denmark published last year linked bystander CPR to a 30 percent lower risk of nursing home admission and brain damage in survivors of cardiac arrest outside of a hospital.

If CPR, shorthand for cardiopulmonary resuscitation, is immediately applied when an electrical malfunction causes a person’s heart to stop, chances of survival, although small, are doubled or tripled. Given that 70 percent of cardiac arrests occur at home, a family member or friend is most likely the beneficiary of bystander CPR. At the very least, housemates of people with known cardiac risk factors — like smoking, high cholesterol, high blood pressure, diabetes, obesity or a prior heart attack — should learn CPR and review the training every two years.

In the 40-odd years since I learned CPR at The New York Times, the American Heart Association has simplified the technique while barely compromising its effectiveness. Although an in-person class with practice on a mannequin is ideal, the current method can be used by untrained people and learned via a brief online video at Hands-Only CPR. For those unwilling or unable to do mouth-to-mouth breathing, the latest technique focuses on critical chest compressions, which — when done correctly — can get blood flowing through the heart and to the brain.

Have someone call 9-1-1 while you start chest compressions, pressing hard and fast at the center of the chest at a rate of 100 to 120 compressions a minute. You can use the beat of the song “Stayin’ Alive” to achieve the desired rhythm, depressing the chest of an adult at least two inches and, without removing your hands, letting the chest rebound between compressions.

If you or a second person is able to perform rescue breathing, two breaths should be administered for every 30 compressions.

The next step would be to restore the heart’s normal rhythm using an A.E.D. To minimize damage, the heartbeat should be restored within five minutes or less of a sudden cardiac arrest. Every minute that passes without this correction reduces the person’s survival chances by 10 percent.

Thus, the life of a person with cardiac arrest often depends on having an A.E.D. nearby and someone who knows where it is and how to use it. You may have seen one in an airport or stadium; they should also be in schools, theaters, convention centers, houses of worship, casinos — everywhere that large groups gather. There are both fully automatic and semiautomatic versions ranging in price from $1,200 to $2,500. If a facility can afford a computer, it can probably afford an A.E.D. I found an at-home package on Amazon for about $1,300.

Although A.E.D. training is recommended, the device is user-friendly and can also be used by untrained individuals. It comes with built-in written instructions and voice prompts as well as safety precautions. The A.E.D.’s computer analyzes the victim’s heart rhythm and determines whether an electric shock is needed. Check “How to use an Automated External Defibrillator” online for instructions from the National Heart, Lung and Blood Institute.

Additional information about A.E.D.s prepared by the American Heart Association is available online at A.E.D. Programs Q&A.

Fear of making a mistake should not be an impediment — Good Samaritan laws in every state and the federal Cardiac Arrest Survival Act help to minimize a lay rescuer’s liability. The alternative is standing by helplessly and watching someone die while you await the arrival of emergency medical personnel.