Institute of Medicine, an integral part of the US National Academies of Science, Engineering and Medicine with charter bound obligation to advise the US Congress has brought a report titled: “Strategies to Improve Cardiac Arrest Survival: A Time to Act” A brief summary of the 458 page report is available at their website. The report was published on 30th June 2015. According to the report, about 600,000 people develop cardiac arrest in the United States annually and it has been cited as the third leading cause of death. As we are aware cardiac arrest is abrupt cessation of functioning of the heart leading to loss of consciousness. It may be noted that heart attack and cardiac arrest are two different entities, though heart attack can cause cardiac arrest. Heart attack is loss of function of a part of the heart muscle due to abrupt loss of blood supply to the region, usually due to blockage of the blood vessel with a clot.
When the cardiac arrest occurs outside the hospital, the survival rates are as low as 6 percent while it is better if it occurs within a hospital where about a quarter can survive to leave the hospital. Of course, the survival depends a lot on the age of the person, associated illnesses and the promptness with which emergency services are available. Even the 6 percent survival for an out of hospital cardiac arrest is just a dream for most of the world where emergency medical aid is just not easily available.
It is well known that chest compressions started immediately after the cardiac arrest is the best way to maintain circulation and life till advanced medical help is available. To achieve this educating the general public on delivering chest compressions (cardiopulmonary resuscitation – CPR) is the best way out. Even in the US only 3 percent of the public receives CPR training annually. Hence the institute of medicine has recommended widespread campaigning on training public to recognize cardiac arrest, initiate CPR and use an AED (automated external defibrillator) when available. AED is a device which shocks back the heart to normal rhythm. The device is being increasingly deployed at public places like airports, bus stations and railway stations. The AED patches when applied to the chest of the victim, detects the electrical activity of the heart and prompts the onlooker when it it ready to give a shock if the cardiac rhythm is a suitable one. If the rhythm is not a shockable one, CPR is continued till a shockable rhythm is achieved or advanced medical help arrives.