Bystander CPR

Bystander CPR

Studies show that the perception of Americans regarding survival from cardiac arrest or “survival from performing bystander CPR” is very high, like 70-75%.   The facts regarding survival rates from out-of-hospital cardiac arrest are nowhere close to that, actually less than 10% nationwide.    Yes, that is terrible.  Would you really be saddened that Atlanta area survival rate is 9.7%, and Detroit averages to 0%?

We have the best EMS system in the world, with some of the finest, most dedicated professionals I’ve ever met.   EMT’s and paramedics will perform CPR on you, even if you’ve been down 40 minutes or are stiff as a board, in the hopes their CPR efforts will be successful.   EMS

Why are survival rates so low?

If EMS folks are so talented and dedicated, then why are survival rates so low?   Well, if they are in your home when you collapse from cardiac arrest, or you happen to work in a fire station!  In those places, someone willing to perform CPR on you is less than 2 minutes away, so you’re fortunate.

In real life, most people don’t live or work next to a hospital or fire station.  Most people suddenly drop to the floor/ground from cardiac arrest, then someone calls 911.  Next, people wait for the paramedics to arrive and begin CPR.  Of course, that CPR is performed on them 7  1/2 to 10  1/2 minutes after their collapse.  That’s generally too late for favorable cardiac arrest survival outcome.  

Your brain without oxygen is a terrible thing to waste, but it’s wasting quickly without someone compressing your chest to circulate blood.  We’re talking in the first 3  1/2 minutes after your heart stops.   In most studies, less than 15% of bystanders perform CPR on strangers, prior to EMS arrival.  In all studies, less than 40% of cases have bystander CPR.   This is the first place a breakdown in the chain of survival occurs, and is the #1 reason for our pitifully low (out-of-hospital) cardiac arrest survival rate.

new Chain of survival

Chain of Survival

There are 4 or 5 steps that, if you take in order and soon, will greatly improve the chances of you or your loved one surviving a cardiac arrest.   They are:

(1) Early recognition of cardiac problem, and access to EMS (seeing someone down/unresponsive & calling 9-1-1).

(2) Early bystander CPR (that means bystanders doing CPR, not waiting for EMS to arrive to perform CPR)

(3) Early defibrillation (communities with high survival rates have dozens of AEDs per 10 square miles.  Most people in GA can’t identify an AED within 30 miles of their house).

(4) Early advanced life support (also called early advanced medical care).

(5) (Not included in all chains) is integrated post-cardiac arrest care.

 

Steps to Survival

All of these steps are needed.  To be blunt, if (2) doesn’t occur until you’ve gone without oxygen for 15 minutes, you might as well forget about calling 9-1-1.  Instead, just call your local funeral home.   Seeing a person collapse or recognizing that a person is unresponsive and needs immediate help starts all of this rolling quickly.  Calling 9-1-1 quickly brings #4 quicker, and sadly #3 (in this area) in almost all cases.  If EMS are the only ones with an AED, and the only ones to do CPR on cardiac arrest victim, then 7 1/2 to 10 1/2 minutes is how long that victim goes without oxygen.   Clearly a bystander doing chest compressions before EMS arrival is the main key to improving cardiac arrest survival.

In an ideal world, someone sees the cardiac arrest victim fall,   then, someone calls 9-1-1 quickly.   Then, a bystander quickly starts chest compressions, and someone else finds and brings a nearby AED.   Then the victim’s heart is shocked back to a normal sinus rhythm, and the victim has a heartbeat and is breathing on their own when EMS arrives.   In many cases in other communities, the victim is sitting up and talking, can provide EMS his name, tells them what hospital he prefers to go to.  Then he gets to call his wife, while EMS monitors his vitals.   Notice, no funeral home is involved!

(Now, why do only 3-5% of cardiac arrests happen like that?)

Hands-Only CPR

Why Few Bystanders Perform CPR

It usually comes down to 3 reasons:

(1) They aren’t confident in their training, it was too long ago, it’s different on a manikin versus their father, or they forgot the key points about bystander CPR.

(2) They are fearful of being sued for causing injury to the cardiac arrest victim.  Or also, they hope or assume someone more skilled, or doctor/nurse/paramedic would arrive and perform CPR better than they would.
Uncle Si from Duck Dynasty
(3) Full CPR involves compressing a victim’s chest to circulate oxygen-rich blood, and breathing mouth-mouth to put air into their lungs.  Bystanders just flat out don’t want to do mouth-mouth on some stranger they don’t know.  Maybe not even on a co-worker they don’t know very well.   Even for relatives, many would prefer not to put their mouth on their father-in-law’s mouth, or their Uncle Si’s.  

 

Bystander CPR, Hands-Only CPR, also called Compressions-Only CPR

Recent studies have shown that for witnessed collapse of a teen or adult, from apparent cardiac arrest, clinical outcomes (victim survival with no neurological damage) are better with Hands-Only CPR.  That is – solely compressing the chest hard and fast, and not doing breaths.   How can that be, don’t humans require oxygen?    Yes, but there is oxygen in the lungs, and oxygen in the blood of the cardiac arrest victim when they collapse, that’s why Bystander CPR works.   What’s missing when the heart stops is the circulation of that oxygen to the brain and vital organs.  So, the latest recommendation from ALL national emergency training organizations is Hands-Only for witnessed collapse of teen or adult from what appears to be cardiac arrest.   FYI, a victim that appears to have drowned, been strangulated, choking or other asphyxiation, or drug overdose – they need compressions and breaths, but start with compressions.   (children & infants need breaths, also).   Hands-Only CPR, or Bystander CPR

High quality compressions – you gotta push hard and fast.  For adults, we’re talking at least 2″ deep, and at a rate of at least 100 per minute.  Allow the chest to fully recoil between compressions.  Part of the science of why Hands-Only CPR even works is that the compression of the chest (and sternum) causes a partial exhalation from the victim’s lungs, and the “bellows effect” of allowing the victim’s chest to recoil draws in some fresh ambient air.   One small plus, is that fresh ambient air is 21% oxygen, while the expiratory breath from the trained responder is only 16% oxygen.

 

Benefits of Hands-Only or Bystander CPR

First of all,  more people are willing to do CPR on strangers, since it doesn’t involve mouth-mouth.   It also helps with the other 2 objections people had/reasons not to do full CPR.  Those being it’s easier to learn, easier to remember, and harder to mess up.   A third reason is it becomes easier for emergency dispatchers to instruct people or family members over the phone how to perform chest compressions.   Most of all, the main benefit is improved outcomes, it saves lives.    Since 2008, the American Heart Association has shown Hands-Only CPR as the preferred treatment for adults or teens that suffer a witnessed collapse from apparent cardiac arrest.   Not to sound like a lawyer, but apparent drowning, strangulation, other asphyxiation or drug overdose victims need chest compressions and breaths, not just hands-only CPR.   Children and infants are more likely to have respiratory issues or choking than cardiac issues – so they need breaths also.

 

Bystander CPR Training (or Hands-Only CPR training)Bystander CPR and Sidewalk CPR logo

Newnan CPR is committed to teaching people Hands-Only CPR in our community.   We will show twice as many people how to perform chest compressions (Hands-Only CPR) this year than we will teach in full CPR (certification-level courses).   OK, we urge all other instructors to do the same.   It takes less than 10 minutes to show someone adult hands-only CPR, and less than an hour for infant/children/adult CPR.

By popular demand – on Halloween Day, we teach “Free Halloween-style Sidewalk CPR“, on the square in downtown Newnan.   Multiple instructors (is it really Mr. T,  Beyonce, and Justin Bieber teaching?)  will teach Hands-Only CPR (non-certification) to whomever comes by.  Treats, too!.

Throughout February (that’s American Heart Month) – we’ll also teach Free CPR (non-cert.) all over the area.  Yes, Newnan, Carrollton,  Sharpsburg,  Palmetto,  Fairburn,  Atlanta.  Fayetteville,  Peachtree CIty,  Tyrone, Hampton,  Grantville,  Jonesboro,  Whitesburg.     https://newnancpr.com/2017american-heart-month-free-cpr/ .

Free CPR Training

We believe that every employer, every workplace, every church, and every family should teach their people adult Hands-Only CPR.  Also, the concepts of full CPR (compressions and breaths) for children and infants.   Of course, we also believe every workplace with 50 employees or 200 visitors per week should have an AED.

We think every community leader should keep the topic on the forefront, pushing for classes and instruction, cause more lives will be saved.   If you are a county, city, or town leader that has a community center, if you provide a facility and get the public to come, we’ll teach the public Hands-Only CPR.   If it’s too far away from Newnan, we’ll try to locate other instructors to teach your people.   This is about saving the lives of people whose hearts are too young to die.   Our hats are off to GA legislature, which passed SB 212 in May 2013.  That bill requires schools to provide training in CPR and the use of an AED before students graduate from high school.   It may be 8-10 years before we see improved cardiac arrest survival rates, but improved outcomes will follow – maybe 1/2% – 1% per year.

 

Can Survival Rates Be Improved with Bystander CPR?

Not everyone that has a cardiac arrest can be saved to live a long life.   Some people just have significant heart damage or disease, and bystander CPR and defibrillation might not be successful.   Experts think 80-85% of them can survive, however.    Hence, can we as a country live with 10%, survival then?    So, we have much room for improvement.   Rochester, MN and Seattle/King County WA both have 55-58% survival rate, why can’t we?    Those communities think they can get to 65% in 2017.   Are we content with 9-10%?   We can duplicate the steps that Rochester and King County took in our community.  It takes more attention on the problem and solution.   It starts with cities and communities training kids in schools, then training adults, encouraging AED deployment by businesses.  We also must keep the topic in the media, and on the minds of the citizens.  

The below schedule is our attempt to help improve bystander CPR rates, by teaching people the life-saving skills of Hands-Only CPR.  
Sure, we’ll be worn out when American Heart Month is over, but a lot of people (hopefully) will have received this life-saving training we offer.   
2017 Free CPR for the Community (Free Hands-Only CPR training):

Community Date Location Times
Newnan/
Sharpsburg
Sat. 2/4/2017Central Library (Thomas
Crossroads)
85 Literary Ln.
Newnan, GA 30265
11:00 am - 12:30 pm
Peachtree CityTue. 2/7/2017Bridge Comm. Center
225 Willowbend Dr.
Peachtree City 30269
3:30 pm - 5:00 pm
Sharpsburg
(old town)
Fri., 2/10/2016Sharpsburg Rec. Center
105 Main St.
Sharpsburg, GA 30277
2:00 pm - 3:30 pm
AtlantaSat. 2/11/2017Kirkwood Library
11 Kirkwood Rd. SE
Atlanta, GA 30317
12:00 pm - 1:30 pm
NewnanWed. 2/15/2017Carnegie Library,
(on the square)
1 LaGrange St.
Newnan, GA 30263
3:30 pm - 5:00 pm
PalmettoThu. 2/16/2017Palmetto Library
911 Cascade Palmetto Hwy.
Palmetto, GA 30268
6:00 pm - 7:30 pm
NewnanFri. 2/17/2017UWG-Newnan
80 Jackson St.
Newnan, GA 30263
1:00 pm - 2:30 pm
TyroneMon. 2/20/2017Tyrone Library
143 Commerce Dr.
Tyrone, GA 30290
10:00 am - 11:30 am
Newnan/
Sharpsburg
Tue. 2/21/2017Central Library (Thomas
Crossroads)
85 Literary Ln.
Newnan, GA 30265
6:00 pm - 7:30 pm
FayettevilleWed. 2/22/2017Fayette Co. Library
1821 Heritage Park Way
Fayetteville 30214
6:30 pm - 8:00 pm
Union CityThu. 2/23/2017Etris Community Ctr.
(Ronald Bridges Park)
5285 Lakeside Dr.
Union City 30291
3:00 pm - 4:30 pm
Grantville Thu. 2/23/2017Grantville Public Library
100 Park Dr.
Grantville, GA 30220
5:30 pm - 7:00 pm
Newnan/
Sharpsburg
Fri. 2/24/2017East Coweta DUI School
(Thomas Crossroads)
20 Tower Way
Newnan, GA 30265
4:30 pm - 6:00 pm
SenoiaSat. 2/25/2017Senoia Library
148 Pylant St.
Senoia, GA 30276
10:00 am - 11:30 am
Newnan/
Sharpsburg
Sat. 2/25/2017Central Library (Thomas
Crossroads)
85 Literary Ln.
Newnan, GA 30265
1:00 pm - 2:30 pm

 

Learn Bystander CPR  –  Save a Life ! 


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