CPR Improvements to Save Lives From Cardiac Arrest

Graham, Margaret, and Andrea explains that cardiac arrest is the third leading cause of death in the united states. There are many different outcomes for cardiac arrest patients across the country. You can have a five times better chances of living just by what city you live in. Many cities and communities are not measuring incidents and outcomes from cardiac arrest. How can we improve cardiac arrest as a country if we are not measuring it? It is almost impossible to improve something if you can't even measure it. Over the last 50 years as a country, we haven't improved the survival of sudden cardiac arrest. A lot of communities have done it individually, but as a country, we haven't improved. 

The data collected nationwide will allow more research to be made as well as look at the best practices that are being done and working. This foundation is necessary to improve OHCA outcomes over the next decades. Chen, Ko, Hsieh, and Ma talked about different methods done to perform CPR. One method was compression only CPR. This is different from conventional CPR. The compression breathe ratio is 30:2, compression only CPR is exactly what is sound like. It is continuous compressions with no breaths. Compression only CPR had better CPR quality than did conventional CPR did this is due to less hands-off time. One downfall to this is appropriate depth decreases more rapidly due to physical fatigue. Conventional CPR allowed an individual to take a break from compressions when giving the two breathes. 

Another method was opposite sides versus the same side. This study looked at the CPR quality given, the outcome, and the time off chest time it took to switch rescuers in a two-rescuer situation. It was found that switching on opposite sides reduced the hands-off time, resulting in higher quality CPR. The next method was four-hands versus two-hands chest compression CPR. This study demonstrated how older females as well as some males may have a hard time getting the correct chest compression depth. Using four-hand chest compression during CPR can significantly improve the chest compression depth in such a situation. 

The last found successful method was heel versus hands chest compression CPR. This method consists of simply using your heels to do chest compressions instead of your hands. It was found that hand chest compression CPR has a higher CPR quality however the heel chest compression CPR does still increase survival rates in situations such as when an individual is alone and is not able to get on the ground, when an individual cannot get sufficient chest compression depth due to a weakness or lack of weight, or when an individual becomes too tired to continue manual compressions. If an individual has a sudden cardiac arrest in the mountains and the bystander is alone and begins CPR while waiting for help to arrive, it may be awhile before help arrives. Imagine doing chest compression CPR for over 30 minutes alone. You would get tired and instead of giving poor chest compression depth you could begin heel chest compression CPR.

Chen et al. also researched assistance via real-time feedback device. This is a device that is put between the victim’s chest and the rescuer’s hands during CPR. This device gives visual real-time feedback when performing CPR. Studies showed that this real-time feedback device for CPR performance improved the quality of bystander CPR. With this device the rescuer could perform higher quality of CPR with higher compression rate and without compromising compression depth.

In general, the goal is to get a national surveillance in all our communities so we can learn from it and improve as a nation and have higher survival rates. Once national surveillance is made of the incidents and outcomes for cardiac arrest the quality of CPR can then be measured. CPR quality can be measured by the chest compression rate, depth, ratio, and ventilation components. There are many variations in care processes and protocols across the united states. 7.7% to 39.9% was the range for OHCA survival rates from ten different sites in united states. 7.7 to 39.9 percent is a huge difference. We as a nation need to look at what’s working by the measurements made and enforce it. This will lower the 32.2 percent gap across the united states putting all communities on the same page increasing the survival rates of OHCA.