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Saving Lives is a Team Effort

Physicians can improve sudden cardiac arrest survival rates by encouraging bystander CPR training
By Vemuri S. Murthy, MD

While the art and science of contemporary medicine are reaching amazing heights of accomplishment in the field of resuscitation science, we need to review the latest evidence-based information involving the combined efforts of physicians and citizens, in order to enhance survival outcomes after a witnessed cardiac arrest.

According to the Centers for Disease Control and Prevention (CDC), approximately 600,000 people die of heart disease in the United States every year; of that number, coronary artery disease kills more than 385,000. The American Heart Association (AHA) reports that in North America there were 359,400 out-of-hospital cardiac arrests in 2013. Bystander CPR was performed in 40.1% of cases, with a survival rate of 9.5%. Clearly, bystander CPR makes a significant impact on the outcome of cardiac arrests.

Nearly 80% of all out-of-hospital arrests occur in private residential settings. Brain death starts to occur within 4-6 minutes if no CPR is initiated. It has been shown that CPR and defibrillator intervention within 3-5 minutes of cardiac arrest result in survival rates of up to 74%. Several recent evidence-based global resuscitation studies reported encouraging results from prompt and high-quality CPR administered by bystanders. A 2012 study indicates that compression-only (hands-only) adult CPR is as effective as conventional CPR.

Therapeutic Hypothermia

There is growing evidence that therapeutic hypothermia can protect the brain after a cardiac arrest. This advance in resuscitation science will lead to even more successful outcomes if appropriate resuscitation is initiated promptly for early return of spontaneous circulation. The pivotal role of bystander CPR in the absence of on-the-scene trained health care providers is obvious.

Role for Medical Societies

In light of the recent advances in the field of resuscitation, physicians are being trained in the latest resuscitation techniques, including early institution of therapeutic hypothermia in selected cases. Medical societies, both state and national, need to promote bystander CPR awareness to the public by partnering with community organizations that are involved with public health. This awareness must also reach the doorsteps of legislators at the state and national levels to support the campaign of “Saving Lives,” in order to enact friendlier Good Samaritan Acts in all states.

Dr. Vemuri S. Murthy is a trustee of the Chicago Medical Society and founder of project SMILE (Saving More Illinois Lives through Education), a project of the Chicago Medical Society and the Illinois State Medical Society.


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