Thousands of people are dying from cardiac arrest every year because Americans do too little to save them, according to a new report.
Huge differences in survival rates –- above 60 percent in some cities but under 10 percent in many others -- show that attitudes and training can save lives, the Institute of Medicine report says.
“Cardiac arrest survival rates are unacceptably low,” said Robert Graham, who chaired the Institute’s independent committee and who directs the national program office for Aligning Forces for Quality at George Washington University.
All it takes is a little training and a willingness to try, says Jonathan Epstein, a paramedic and CPR instructor for the American Red Cross in Washington.
"They need to be willing to get down on the ground and help."
“Don’t be afraid,” he told NBC News. “We need to have family members, bystanders, co-workers ready to act. They need to be willing to get down on the ground and help,” he added.”
Cardiac arrest is different from a heart attack. Heart attacks can cause cardiac arrest which, as the name implies, is when the heart stops beating. Electrical irregularities can also cause cardiac arrest.
But just because someone’s heart has stopped doesn’t necessarily mean he or she is dead and people need to understand that they can help, the Institute’s report said.
“Don’t worry about doing anything wrong. You really can’t hurt the person, only help them,” said Epstein. “Pushing hard and fast is what I would tell everyone to do. Call 911.”
The Institute’s report says that more than 1,600 people suffer a cardiac arrest every day in the United States. That adds up to 600,000 a year, and almost all of them die. Fewer than 6 percent of people suffering cardiac arrest outside a hospital survive, and just 24 percent of those who have one in a hospital survive.
“Equally unacceptable are the disparate survival rates within our population,” the report reads. “Minorities and those in the lower economic strata fare worse compared to others. And where one resides is determinant of survival.”
Some places, such as Seattle and Boston, have much higher survival rates. “In some communities more than 60 percent of persons with out-of-hospital cardiac arrest (due to bystander-witnessed ventricular fibrillation) survive and are discharged from the hospital,” the report reads.
“In far more communities, the survival rate is 10 percent or less. Why is this and what can be done?”
One big factor is an uncoordinated emergency and hospital response, the report found. The fact that some communities have brought up survival rates so dramatically shows it can be done everywhere, however.
Training people in cardiopulmonary resuscitation can also really help, says Epstein, as does having automated external defibrillators (AEDs) handy. Emergency medical service personnel must be trained to respond quickly and correctly, 911 operators can be trained to talk people through CPR while an ambulance comes, and hospital emergency departments need smooth, coordinated responses.
Yet only 3 percent of the population gets CPR training each year, the report said.
Training is important, but Epstein says people can save lives even if they are not trained.
“Push every half second, push hard and push fast and that is absolutely the best thing we know that will improve chances of survival."
A quick call to 911 should come first, he said. Then people need to help the patient fast.
“The most important thing we can tell the public (is) when you recognize that someone has collapsed suddenly, even if they are unresponsive and show no signs of life, start chest compressions,” he said.
There’s no need to breathe into someone’s mouth. Just pushing hard on the chest, over the heart, can keep blood pumping to the brain. “Press down two inches in depth at a rate of 100 to 120 times per minute,” Epstein said. “Push every half second, push hard and push fast and that is absolutely the best thing we know that will improve chances of survival,” he added.
“For every minute we waste of not starting CPR…we lose about 10 percent of survivability.”