You are enjoying the nice weather in the local park when you witness a nicely dressed male sitting on a bench suddenly slump over. The first thing you remember from a recently attended basic life support (CPR) course is to shout for help and check for responsiveness. The male is not responding, not coughing, and has no pulse. The most likely cause for this condition is sudden cardiac arrest (SCA.)
SCA is defined as a sudden and unexpected cessation of a cardiac mechanical activity most commonly referred to as a pulse. This causes the normal flow of blood through our vessels which supplies our organs with oxygen, to stop. It is reported that the occurrence of SCA is about 1,000 each day.
The major cause of SCA is coronary heart disease. One huge hurdle for patients and healthcare professionals is that many patients who experience SCA had no prior symptoms or complaints. This is why I always encourage you to be honest and open with your healthcare professional. The conversation regarding your symptoms or complaints may uncover an untreated condition. Other risk factors include a family history, recent heart attack, congestive heart failure, and drug and alcohol abuse.
One other cause for SCA is Commotio Cordis. This is a sudden blunt trauma to the left side of the chest and is different from a cardiac contusion usually occurring from a motor vehicle collision. The most common venue for Commotio Cordis is baseball with a line drive hitting the pitcher in the chest. There has been an increase of players, especially in little league, wearing a chest plate. The chest plate is designed to protect the chest area and lessen the blow. Softball and hockey are two other sports which this phenomenon occurs. It occurs in mostly young males but can occur to anyone.
The Sudden Cardiac Arrest Foundation reports that there is about a 10 percent survival rate for SCA with EMS initiating treatment alone. One factor is 60-percent of SCA occurs in the home and relies on someone being with the victim to contact 911. The survival rate rises to 40 percent when CPR is initiated and an automatic external defibrillator (AED) is utilized. Learning CPR can be accomplished by attending a course at a local hospital, EMS station, or fire department. This training can and has saved many lives.
The AED is a tool that is becoming more prevalent in communities. It was only EMS, and more recently fire apparatus and law enforcement, who carried them in their vehicles. Today, you will find an AED in churches, airports, athletic clubs, and schools. You may also see them in corporate offices and department stores. Each state defines the mandate for organizations in their state.
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An AED works by stopping the unorganized, non-pulse producing rhythms called ventricular fibrillation or ventricular tachycardia. The heart has specialized cells that will restart the electrical impulses causing the heart muscle to beat and generate a pulse. This process must happen rapidly for the victim to have a chance. Having an AED is often a lifesaver. There are ceremonies and luncheons nationally to celebrate the survival of a patient experiencing SCA. It is an opportunity for the victim to meet the person or persons who participated in the resuscitation.
There are many survivors locally and nationally who have been resuscitated by citizens who attended a CPR course or an employee who received training in the use of an AED. Being prepared by learning CPR and having an AED available have translated into increased survival rates. These steps are just as important as calling 911 and having EMS and the emergency departments facilitate excellent care.
SCA is not preventable or predictable but by being trained and equipped you can prepare your home or organization to react quickly. Your healthcare provider can provide you with more information and discuss what actions you can take to decrease your chances of experiencing SCA. As always eating healthy, exercising regularly, and attending scheduled health exams will be beneficial. Organizations with an AED at their facility and CPR trained members or employees will increase the chance of survival.
There is a national initiative attempting to place more AED in communities and organizations. The information and statistics support the benefit of this initiative. Creating a safer and more prepared household or organization will be beneficial to all.
Questions and or comments regarding this week’s health column please contact William Torres Jr., EMS Department Head at Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!