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One of the most common causes of death in the world is ischemic heart disease. Sudden Cardiac Arrest (SCA) leads to death in over 60% of coronary diseases. This death can often be prevented by immediately initiating CPR, which is compressions on the chest to keep the blood flowing, and rescue breaths to deliver oxygen to the brain. Knowing about first aid helps to prevent the death of our loved ones and people we meet, before the ambulance arrives.
Annually, across Europe, it reaches approx. 700 thousand. cardiac arrest. Thousands of men and women lose consciousness and die from cardiac arrest or heart attack. Statistically, an ambulance service in the centers of large cities reaches the victim in 8 minutes. How is it really? We know ourselves. It is not uncommon that the injured person has to wait and a half an hour. In 80% of cases of sudden cardiac arrest, defibrillation is required, i.e. an electrical pulse is passed through the heart in order for the heart to start working coordinatedly. When the heart does not contract but trembles and does not pump blood, the result is a lack of oxygen delivery to the brain, heart and other vital organs. Every minute without oxygen delivery to the brain brings us closer to death. After about 4 minutes there is the first irreversible changes in the brain. The only proven treatment for this condition is defibrillation as soon as possible and good-quality cardiopulmonary resuscitation (CPR). Each 1 minute delay in defibrillation reduces the chance of survival by 7-10%. It is easy to calculate that after 10 minutes without defibrillation and cardiopulmonary resuscitation the victim has little chance of survival. Fortunately, someone invented basic life support procedures (BLS) that effectively buy time up to 3-4 times increasing the chances of survival. BLS can prevent damage to vital organs such as the brain and heart. CPR does not restore heart rate in most cases. However, good CPR, especially chest compressions, increases the likelihood of successful defibrillation when the defibrillator is delivered.
At the same time, Automatic External Defibrillators (AEDs) are becoming more and more popular, located in public places, gatherings of a large number of people, where there is the greatest probability of SCA occurrence, dramatically reducing the time from SCA to the first defibrillation. Such devices are completely safe and, after activation, lead us through the next steps of resuscitation with voice commands. AEDs cannot do harm, and can save lives if we know where they are and dare to use them. It is enough for a trained person to be in the area, and the injured person gains great chances of survival. Such defibrillators are marked with the international symbol AED, so no matter which country we are in, we know how to look for them. Therefore, all initiatives, both public and private, aimed at increasing the number of AEDs on the streets of our cities are particularly commendable. Common access defibrillation programs have been introduced in several Polish cities: Kraków, Trzebinia and Warsaw. Thanks to such programs, AEDs are placed in public places and people are trained to efficiently use them.
All activities necessary to save human life have been described as the chain of survival. The first three links belong to us – to outsiders. Firstly, recognize SCA and call the ambulance team as soon as possible by calling 999 or the international emergency number 112. Secondly, start BLS – thanks to this, we will “buy” our victim time until the ambulance arrives. And third, if available, use an AED.
Below, we present an algorithm for dealing with adult loss of consciousness for all laypeople, regardless of the cause (non-traumatic injured), according to the 2005 European Resuscitation Council Guidelines for CPR. If we are not qualified lifeguards, the same scheme can be used in children.
Basic Life Support Algorithm:
seeing a person unconscious or losing consciousness …
1. Assess SAFETY
2. Check that the person is CONSCIOUS
3. Call for HELP
4. Check the BREATH
5. CALL THE EMERGENCY -999 or 112
6. Begin the CHEST COMPRESSION 30x
7. Perform 2 RESCUE BREATHS
8. Continue on 30/2
a. until the ambulance arrives
b. loss of strength
c. taking over the injured by the team.
If we do not feel confident, and we would like to not only know theoretically but also thoroughly, practically practice what we should do in such situations, we can take part in Basic Resuscitation Procedures and the use of Automatic External Defibrillator courses organized throughout the country by various organizations.
The Polish Resuscitation Council is an association responsible for the implementation of the latest guidelines for cardiopulmonary resuscitation in Europe on behalf of the European Resuscitation Council. Soon, on October 18, 2010, the latest guidelines will be announced, based on the five-year research and improvement period of the previous edition.
Please visit the website www.prc.krakow.pl where you can follow the process of creating and implementing new guidelines as well as find an offer of training in resuscitation at various levels of advancement.
Text: lek. med. Bartosz Frączek
Head of the BLS / AED Working Group of the Polish Resuscitation Council
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