Emergency First Aid Treatment for Sudden Cardiac Arrest

Someone suffering from a sudden cardiac arrest (SCA) will collapse, become unconscious, and stop breathing as their heart suddenly stops working.

A sudden cardiac arrest is a life-threatening emergency, where response time is of the essence.

But would you know what to do if a loved one, a co-worker, or someone you saw on the street suddenly collapsed and their heart stopped beating?

Sudden and unexpected cardiac death is the most common death worldwide, accounting for more than 17 million death every year. From those statistics, 25% or an equivalent of four million and two hundred fifty-thousand (4,250,000) is due to sudden cardiac arrest.

According to a study from the National Library of Medicine (National Center for Biotechnology Information), the survival rate from sudden cardiac arrest is less than 1% worldwide.

In Australia, the estimated survival rate from sudden cardiac arrest is at least 12% and can reach up to 25% if the attack is witnessed and intervened by a bystander.

The Bystander Effect on out-of-hospital Cardiac Arrest

As mentioned, only 12% of Australians survive cardiac arrest in an out of hospital setting, but that percentage could increase significantly if bystanders, or people around the incident scene, can recognise and perform simple life-saving procedures.

According to the emergency medicine physician of the University of Virginia, William J. Brady, "Early emergency care by the bystander, long before emergency medical providers arrive, can save a life. This care is referred to as pre-arrival care.”

“Faster recognition of cardiac arrest will also lead to quicker emergency services call, speeding the arrival of trained emergency medical providers,” said Brady.

Calling your local emergency hotline, Performing CPR

According to Sharon McCulloch, lead trainor in The First Aid Course Sydney, The first step in a cardiac emergency is simply noting that someone may be having a cardiac arrest.

Once you noticed the signs, it is recommended that bystanders should suspect cardiac arrest and begin to perform cardiopulmonary resuscitation (CPR) whenever they see a person unresponsive and not breathing.

Faster recognition of sudden cardiac arrest and its signs will also lead to emergency call, speeding the arrival of training emergency medical providers.

The signs and symptoms of sudden cardiac arrest to look out for according to the Heart Foundation Australia.

• Chest pain or discomfort
• Heart Palpitations
• Rapid, irregular heartbeats
• Fainting or near fainting
• Loss of consciousness
• Low pulse or no pulse at all
• Difficulty in breathing or not breathing at all

When performing CPR to a sudden cardiac arrest victim, do the following:

Check for breathing

Quickly check if the person is breathing. Put your face near their nose or mouth and see if their chest is rising. If the person has abnormal breathing or isn’t breathing at all, start administering CPR.

Perform CPR

When administering CPR, remember to push hard and fast. Push down at least to inches at a rate of 100 to 120 pushes per minute in the center of the person’s chest just below their nipple. Push hard and fast to the beat of the song Stayin’ Alive as it is the proper ratio that could give the victim of sudden cardiac arrest a fighting chance.

After each push, allow the person’s chest to come back up to its normal position for a much effective CPR.

Use an AED

If you are unable to locate one, ask bystanders to look while you perform CPR. Do not leave the victim unless someone is taking over the resuscitation. Prolonged pauses in CPR will decrease its effectiveness and may affect the person’s chances of survival.

If available, use the automated external defibrillator (AED) as soon as it arrives. Switch the on button and follow the voice prompt.

Keep pushing

Continue administering CPR until a person starting to show signs of life, is starting to breathe, or until someone with more advanced training is ready to take over such as paramedics and EMS members.

It is essential that bystanders have the skills and knowledge of CPR intervention. Chest compressions that are high in quality are important to best practice in CPR. A resuscitation that is focused on having the correct compression rate, depth and time off the chest is critical in improving survival rates and neurological outcomes.

There should be minimal CPR interruptions or no interruptions at all if we want to achieve the best possible results.

How AEDs Can Help

The use of a defibrillator (AED) can further help in increasing a person's chances of survival. Multiple papers and studies have shown the benefits of having accessible for use by members of the public, including schools, malls, and workplaces.

A 2018 study involving 50,000 cardiac arrest cases have found out that more than 66.5% (33,250 people) who were treated with an AED by bystanders survived, in comparison to the 43% survival rate of people who were only shocked after emergency responders arrived.

This study highlights the importance of using AED with CPR, as well as the benefits of quick action from bystanders.

For every minute that a victim of sudden cardiac arrest in an out-of-hospital setting goes without CPR and defibrillation, the chance of survival decreases by 7 to 10%.

Life After Cardiac Arrest

If one is lucky to survive an arrest, an overall assessment will be made to identify the cause and also discuss the treatment option to reduce the risk of having another sudden cardiac arrest.

• Life after a cardiac arrest will most likely depend on:
• How much brain damage occurred during the attack
• The time between the collapse and the start of CPR/defibrillation
• The quality of CPR/defibrillation
• The amount of time a brain activity started after the arrest

Many people have survived a cardiac arrest and gone to live a happy, healthy, and fulfilling life after. This is due to bystander's courage, skill, and knowledge of first aid techniques applied in a cardiac arrest emergency.

Following the three basics of first aid: calling your local emergency hotline, perform CPR, and using a defibrillator will certainly give victims a higher chance to return to their lives and families.