An experience of sudden, unexpected loss of heart function, breathing and consciousness is a state of medical emergency. Sudden cardiac arrest occurs when the diseased heart’s electrical system malfunctions, producing an abnormal rhythm, disturbing the pumping action and stopping blood flow to the rest of your body.
Cardiopulmonary resuscitation (CPR), a lifesaving technique consists of the use of chest compression and artificial ventilation to maintain circulatory flow and oxygenation during cardiac arrest.
- A family history of cardiac arrest in a first-degree relative (parents, offspring, siblings) is associated with a two-fold increase in the risk of cardiac arrest.
- In India, 95% of those who experience sudden cardiac arrest die because they do not receive life-saving first aid within 4 to 6 minutes.
How is Cardiac Arrest differ from a Heart attack and what causes it?
A heart attack is a circulation problem but a sudden cardiac arrest is an electrical problem. The only link between them is that sudden cardiac arrest can occur after a heart attack, or during recovery and heart attacks increase the risk for sudden cardiac arrest. Cardiac arrest is clinically characterized by unresponsiveness, the absence of breathing and absence of the pulse.
Cardiac arrest can occur due to:
- Heart disease
- Haemorrhage – head / chest / abdominal trauma
- Electrical shock
- Asphyxia – gases / fumes
- Respiratory illness
- Following a respiratory arrest
- Family history of sudden cardiac arrest or other heart diseases
CPR is a combination of techniques, including chest compressions which cause circulation of the blood so it can provide oxygen to the body, and the brain and other organs stay alive until definitive treatment happens. It should be administered as quickly as possible and to unconscious, unresponsive or to the person who is not breathing or not breathing normally.
CPR can be learnt properly by taking an accredited first-aid training course.
What to do?
For an unconscious adult, CPR is initiated as follows:
1. Before beginning, look into the patient’s mouth for foreign bodies blocking the airway.
2. Give 30 chest compressions as follows:
- Place the heel of one hand on the patient’s sternum and the other hand on top of the first, fingers interlaced.
- Extend the elbows and lean directly over the patient.
- Press down, compressing the chest.
3. After 30 compressions, perform a mouth-to-mouth technique as follows to give 2 breaths (the 30:2 cycle of CPR):
- Pinch the patient’s nostrils closed to assist with an airtight seal.
- Place your mouth completely over the patient’s mouth.
- Give each breath for approximately 1 second with enough force to make the patient’s chest rise.
- Failure to observe chest rise indicates an inadequate mouth seal or airway occlusion.
4. An intubated patient should receive continuous compressions while ventilations are given 8-10 times per minute.
5. Repeat the entire process until pulse returns or the patient is transferred to definitive care.
6. Perform the head-tilt-chin-lift movement to open the airway and determine if the patient is breathing.
- The compression depth for adults should be at least 2 inches. The compression rate should be at least 100/minute.
- To prevent provider fatigue or injury, new providers should intervene / swap every 2-3 minutes.
Prevent Cardiac Arrest:
Lifestyle changes are the best ways to reduce the risk of sudden cardiac arrest.
- Quit smoking
- Lose weight
- Exercise regularly
- Consume a low-fat diet
- Manage diabetes
- Stop recreational drug use
1. Sudden Cardiac Arrest Foundation. Accessed Oct 12, 2016.
2. Victoria State Government. Accessed Oct 13, 2016.
3. American Red Cross. Accessed Oct 13, 2016.
4. Sudden Cardiac Death in India: A Growing Concern; Journal of the Association of Physicians of India; Accessed Oct 14, 2016.