Sudden Cardiac Arrest Chain of Survival

Sudden Cardiac Arrest Chain of Survival

August 10, 2021

According to the American Heart Association, over 350,000 sudden cardiac arrests happen outside of the hospital each year and about 90% of these people die. How can the survival rate of sudden cardiac arrest go up?
There are many things that need to be done, but one important factor is training more lay rescuers how to be prepared to save a life in the event of a cardiac emergency. The American Heart Association has developed a chain of survival that includes six crucial steps to saving someone’s life.
The links to the chain of survival are:
1)  Activation of Emergency Response
2)  Early CPR
3)  Rapid Defibrillation
4)  Advanced Resuscitation by Emergency Medical Services
5)  Post Cardiac Arrest Care
6)  Recovery
We are going to discuss in detail the first three links in the chain of survival below.

Activation of Emergency Response

The first step in the chain of survival includes assessing the scene and activating the emergency response team. In the United States, that means calling 9-1-1. When someone collapses, there are a few, quick steps you need to take before starting CPR.
You always want to make sure the scene is safe for you to help. Once you are sure the scene is safe, you want to kneel down next to the person and check if they are responsive. To do this, give them a hard tap on their shoulders and yell, “Are you ok, are you ok?” Someone in sudden cardiac arrest is completely unresponsive and will not respond to you hitting them or yelling at them.
Then, call for HELP! It is your job to assign people crucial lifesaving jobs. You need someone to call 9-1-1, another person to go get the AED, and the third person to go outside and wave down the ambulance. Make sure you point at these people and make it very clear who is doing what job. If no one is around, call 9-1-1 and put the phone on speaker mode. Listen to the dispatcher as they are going to help you save a life!
Finally, check for breathing. Look for chest rise to determine if a person is breathing. If the chest is moving up and down and you are sure the person is breathing, you don’t need to perform CPR. Remember, if you have any doubt, chances are the person needs CPR right away. Oftentimes, someone in cardiac arrest will start agonal gasping which sounds like a snore, snort, groan, or a long drawn out breath. This is NOT normal breathing and this person DOES need immediate CPR.
This all happens quickly. Ideally, we want to start performing CPR within 10 seconds of someone collapsing. This will give the person the best possible chance of survival.

Early CPR

CPR consists of two steps: giving chest compressions and giving breaths. Chest compressions are the most important part of CPR and we are going to focus on them here. If you are not in a position where you are comfortable giving breaths, you can provide “hands only CPR” to save a life. Hands only CPR means you are performing chest compressions only.
To perform CPR, you want to be kneeling very close to the side of the person. Ideally, the person is lying on their back, on a HARD, FLAT surface. You put one knee at their shoulder and one at their waste. It is important to be up, over the person’s body. CPR can get very tiring, very quickly so you want to use your body weight to help you push down when performing chest compressions.
Place the palm of one hand right in the center of the chest, on the breastbone. Interlock your other hand on top of your first hand. Keep your elbows locked in and push down hard and fast on the center of the chest. You want to go at a rate of 100-120 compressions per minute. The key: go hard and fast.
When performing hands only CPR, don’t stop until either an AED arrives or until the ambulance arrives.

Rapid Defibrillation

CPR is very important. It is going to keep blood flowing when the heart stops pumping and it is going to buy time for the person. Ultimately someone in sudden cardiac arrest needs to be shocked by an AED quickly to survive.
The most important point to remember when using an AED is to turn it on! Once you turn it on, an AED will tell you step-by-step instructions on how to use it. Our Lifeline VIEW AED will also show you a video of what to do. The machine will tell you to remove clothing because the pads need to be placed on bare skin.
The defibrillator pads will have pictures on them, showing you where to place them. One goes upright on the right side of the chest under the collar bone. The other goes on the left side of the rib cage, under the armpit. There are different pads for adults and pediatric patients. Pediatric patients are those eight years old or younger. If you don’t have pediatric pads, you can use adult pads on a child. Place one AED pad in the middle of the chest and the other in the middle of the back between the shoulder blades.
Once the AED pads are placed correctly, the machine will start to analyze and tell you to “stand clear.” Make sure no one is touching the body, including you. If a shock is advised the machine will tell you to stand clear and it will start charging. Finally, it will tell you to push the shock button. Make sure the body is clear of anyone touching it before pushing the shock button. After you push the shock button, the machine will tell you to start performing CPR if needed. The device will have a metronome. Deliver CPR to the beat of the metronome. It will do this for two minutes before analyzing again and determining if a second shock is advised. The machine will continue to work in two minute cycles.
Remember, turn the AED on! AEDs are easy to use and are meant to help you SAVE A LIFE! Anyone can perform CPR and use an AED. You don’t need certification to save someone’s life.
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