January saw the launch of the British Heart Foundation’s (BHF) “Hard & Fast” campaign featuring football and TV hard man, Vinnie Jones.
The survival rate for cardiac arrest is low, due partly to the fact that most people don’t know how to do CPR, and few are willing to have a go. The BHF campaign aims to address this by getting more of those not trained in CPR (compressions and mouth to mouth ventilation) to have a go at giving compressions only.
Research has shown that one of the main reasons untrained people don’t attempt CPR is the fear/reluctance associated with giving ventilations. Only having to do the compressions it is hoped, will remove this factor and encourage more people to attempt (compression only) CPR. It is hoped that this will eventually lead to an increase in the survival rate which is currently only around 7-10% in the UK.
While the policy is supported by the UK Resuscitation Council, their 2010 guidelines state rescuers should combine compressions with ventilations unless they are “unable or unwilling to give ventilations” in which case they should just give compressions. This is what is taught on first aid courses in the UK.
So why have two standards? The answer is all about time. When the oxygen supply to the brain is cut off suddenly, the brain cells start to die within 3-4 minutes. If the supply is not restored within 10 minutes the brain itself will die.
The aim of CPR is not, contrary to what you are told on the TV, to re-start the heart, which would have stopped due to a blockage of one or more of the coronary arteries. The aim is to maintain the oxygen supply to the brain, slowing down the death of the brain cells. This buys time to get the casualty to definitive medical care where hopefully, they maybe able to restore the blood supply to enough of the heart muscle to reinstate circulation of blood to the vital organs.
It is estimated that when a person collapses in cardiac arrest they have around 5 minutes worth of oxygen in the blood so by just giving compressions you can still slow down the death of the brain cells. The problem with compression only CPR is that once this reserve is used up, the effectiveness of the compressions begins to drop.
The ambulance service aim is to get to emergencies like cardiac arrest within 8 minutes. While most services achieve an average response time of around 6 ½ minutes, the actual times can be much longer due to the geographical location of the incident, the number of calls being dealt with by the ambulance service and the quality of the information given to them.
CPR is not an exact science and there are other factors which will effect the likelihood of the casualty surviving. The gold standard at this time is, wherever possible to perform full CPR however, there is no doubt that if we simply get more people “having a go” more people will survive.
But here we should raise a note of caution. While it is important to spread the message that it is better to do something rather than nothing, we must also make people aware that the adverts do not show how stressful/hard it is to give compressions, nor the fact that even if you do full CPR, most casualties will not (as seen in the advert) suddenly sit up and come back to life.
Although as a final point we should say that those who do survive, will owe their lives to those who stopped and had a go.
