Why It Matters Where You Have A Cardiac Arrest

Jul 1, 2015

State lawmakers introduced a bill requiring Automated External Defibrillators, or AEDs, in all middle and high schools. But the legislation never made it past a House committee.

Leaving that legislation on the table could have consequences.

During a class at the Rhode Island Foundation, RIPR staff and others practice CPR on mannequins.
Credit Kristin Gourlay / RIPR

There’s a new report from the Institute of Medicine exploring ways to improve cardiac arrest survival rates. The report’s authors estimate more than 600,000 Americans experience cardiac arrest each year, about 12,500 of them children. It’s a treatable medical condition, but there are huge disparities in survival rates between communities. That’s because most cardiac arrests happen outside a hospital setting, where a victim’s survival depends on community preparedness.

"Following a cardiac arrest, each minute without treatment decreases the likelihood of survival with good neurologic and functional outcomes.”

The key is to get chest compressions started ASAP, to keep blood flowing to the brain and major organs, while someone calls 911. The best scenario includes an Automated External Defibrillator or AED, which can restart a normal heart rhythm, and continued CPR until an ambulance arrives.

That means someone near you – at the dinner table with you, walking down the street beside you, standing behind you in line at the grocery store – has to know CPR. But the IOM report points out that less than three percent of Americans have been trained. That pales in comparison to some other nations.

"Some European countries mandate first aid training, resulting in as many as 95 percent (Norway) and 80 percent (Germany) of the public trained in CPR and AED use (IFRC, 2009)."

In the U.S., your survival can be affected by “…individual demographics (e.g., race, age, gender, health status), location of arrest, initial cardiac arrest rhythm, rates of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, and the characteristics of emergency medical services (EMS) and health care systems (e.g., response time, treatment availability, training, and care quality)."

Disparities in cardiac arrest survival rates
The IOM report’s authors combed through available data about survival rates, and found that whites are sometimes twice as likely to survive a cardiac arrest as blacks and Hispanics. Blacks and Hispanics are more likely to experience cardiac arrest in the first place. And these groups have lower access to the right treatments.

They also found evidence of less frequent use of the 911 system in black and Hispanic neighborhoods, and lower rates of CPR training.

Should kids be trained in CPR?
The IOM report points out there’s good evidence that bystander CPR and AED use can not only improve survival (by as much as 50 – 500 times) but overall outcomes for victims of cardiac arrest (lowering the risk of irreversible brain or organ damage, for example). Here’s their recommendation for schools:

“State and local departments of health and education, and leading organizations in cardiac arrest response and treatment should partner with training organizations, professional organizations, public advocacy groups, community and neighborhood organizations and service providers, and local employers to promote public awareness of the signs, symptoms, and treatment of cardiac arrest. These efforts require public cardiopulmonary resuscitation (CPR) and automated external defibrillators (AED) training across the lifespan, creating a culture of action that prepares and motivates bystanders to respond immediately upon witnessing a cardiac arrest.”

Recognizing cardiac arrest
Do you know the difference between a heart attack and cardiac arrest? I didn't either, until I took a CPR class.

During cardiac arrest, the heart stops – unexpectedly, and often with no warning signs. The victim collapses, goes unconscious, and stops breathing.

During a heart attack, blood flow to the heart is blocked. The heart usually continues beating, and the victim remains conscious. They might experience pain or shortness of breath for hours before the heart attack actually happens.

Both require immediate medical attention. But someone in cardiac arrest will die within minutes without it. That’s why where you experience cardiac arrest matters.

Want to get trained in CPR? Search for courses via the American Heart Association or the Red Cross.