A multitude of links exists between human psychology and physiology. In a sense, we’re biological machines responding to chemical programming. You’ve probably heard an expression such as you are what you eat or garbage in garbage out.
When it comes to reacting in a tense situation, the more confident that we can have a non-determinantal effect weighs more heavily than our belief we can help. The bystander effect is more about not wanting to cause a problem than a fear freeze.
The purpose of this review is to demonstrate that bystander CPR always helps more than it harms. Yes, you need to be familiar with CPR techniques and the expansive technology available for emergency services. Surviving a sudden cardiac arrest (SCA) depends on action more than the quality of that action.
Those with a CPR certification acting immediately more than double a person’s survival chances.
Bystander CPR by the Numbers
First, by CPR we are referring both to manual cardiopulmonary resuscitation and the expansive use of devices meant to shock a heart into rhythm.
Devices such as defibrillators and automated external defibrillators (AED) use an electrical shock. This shock, in the case of an abnormal rhythm, forces the heart to stop before forcing it to beat again.
For more information about the development of AED and their vital use in offices and work settings read here.
Every minute between the onset of an SCA and the use of an AED or start of CPR limits the chances of survival. Studies show that survival chances decline by as much as 10 percent per minute.
It seems the American public needs constant reminders on what to pay its limited social attention on. Some leading causes of death make for splashier headlines and get more coverage, leading to a disproportionate concern about the risks of cancer, gun fatalities, and vehicle fatalities.
The leading cause of death in the US continues to be cardiovascular disease. The single risk factor accounts for nearly 1 in every 3 deaths.
Cardiovascular disease presents itself in the forms of stroke, SCA, and heart attacks. Each of these presentations van be subtle or violent, skewing our response to them.
It doesn’t help that film and television have a long history of making these events more dramatic, further confusing our perception of an onset.
- Heart Attack- strikes every 40 seconds
- Heart Attack – cost $204 billion annually
- Stroke – also strikes every 40 seconds
- Stroke – causes most long-term disabilities
- SCA – strikes 39.5 percent of the time in public
- SCA – accounts for over 1/3 of cardiovascular deaths
Even this scant cross-section of the risks associated paint aa picture of how necessary early intervention can be. If more people were trained in CPR and knew when to use CPR, that final number could diminish dramatically.
In the US it’s estimated that fewer than 20 percent of people have any kind of CPR familiarity or training. Of those 20 percent, only 15 percent perform CPR in public during an emergency situation.
A large-scale pilot study in Denmark looked at how improving the bystander response rate affected SCA survival. The findings indicated that increasing bystander response to 30 percent doubled the 1-year survival rate of SCA sufferers.
It’s important to note that the number for the public doesn’t necessarily mean on the street. The same study indicated that 88 percent of SCAs occur at home.
Having a family member trained and ready to provide emergency CPR drastically increases survival rates. This becomes more necessary with an aging population.
Stroke and heart attack risk peak at 72 and rise after 46.
Outside of preparation to take action in the event of an SCA, reducing risk factors delays the onset of problems.
Topping the list of risks for cardiovascular disease are smoking, nutrition, and obesity. Issues with cholesterol and blood pressure come in second.
- Nutrition – dietary scores improve over time but early deficits cause larger problems
- Smoking – average age to start is 17.9 years
- Obesity – 37.7 percent of adults and 33.4 percent of children are overweight or obese
As you see, age and early prevention have a strong correlation to avoiding issues later in life.
Out-of-Hospital Cardiac Arrest (OHCA)
So far, the numbers have reflected incidents in which an SCA or other cardiac events happen outside of a hospital setting.
Not only do these count for the vast majority of events, but they also represent the largest danger to survival rates both before and after hospitalization.
While SCA events occur more frequently to men than women, women have a lower overall survival rate. Interest in gender variance in care has led to an understanding that too much emphasis is placed on estrogen as potential cardiac protection.
- First attack – Men 66, women 72
- OHCA shockable cases – 29 percent men, 16 percent women
- Unwitnessed SCA – 46 percent men, 52 percent women
- Response rates – 6 percent more bystanders attended to men than women
- Survival rates – 36 percent of men, 35 percent of women
While not conclusive and bearing a need for more study, these numbers indicate that women are overlooked as targets of SCA issues.
In-Hospital Cardiac Arrest
Only 20 percent of cardiac events occur in a hospital. Hospital survivability numbers increase from 11 to 35 percent.
This increase in survivability strongly reflects the same results a person experiences when given immediate CPR care in public.
Expansive guidelines and access to proper equipment make up some of that gap. The rest comes from the ability to establish proper aftercare. A hospital stay of eight days or more increases 1-year recovery rates.
It takes dedicated training, not only in how to perform CPR or use an AED but also the mental training to act when needed. Keeping up on these essentially paired skills enables you to use bystander CPR to save lives.
It’s no small feat to take action when needed. Contact us for training materials and a broad spectrum of information on devices and services.