What is cardiac arrest?
Cardiac arrest is sudden stoppage of the pumping activity of the heart. The vital organs cease receiving oxygenated blood and stop functioning soon. The person loses consciousness soon and falls down due to loss of postural muscle tone. A superficially similar situation is a fainting attack, which is transient and recovers spontaneously. Cardiac arrest can be recognized by absence of pulses and gasping or absent breathing. Unless immediate steps are taken to restore the functioning of the heart, the brain becomes dead and the person cannot survive. Measures to start the heart pumping has to take place within the vital 4 minutes for best results.
What are the types of cardiac arrest?
Cardiac arrest could be due to two types of electrical mechanism. One is complete cessation of all electrical activity of the heart, known as asystole. The other type is a fine irregular electrical activity known as ventricular fibrillation. Ventricular fibrillation is the more common mechanism and is a fine irregular, very fast electrical activity which does not permit organized contraction of the ventricles (lower muscular chambers).
What is conventional cardiopulmonary resuscitation of a cardiac arrest victim?
Conventional cardiopulmonary resuscitation involves supporting the heart beats and the breathing. First the airway has to be cleared of any obstruction and the chin has to be lifted up to prevent the tongue from blocking the throat. After this mouth-to-mouth breathing can be given by taking a deep breath and blowing into the mouth of the victim, keeping the nostrils closed. Regular chest compressions are given to squeeze out the blood from the heart into the circulation. Fifteen compressions for every two breaths is a standard ratio and you need about 100 compressions per minute. Compressions of the chest should be firm enough to depress the breast bone (sternum) by about 5 cm. Care should be taken to avoid fractures of ribs, which can injure the heart.
Why people are hesitant to give cardiopulmonary resuscitation?
Since cardiopulmonary resuscitation involves giving mouth-to-mouth breathing, many are hesitant to do it for a stranger. It is mostly due to fear of acquiring infections from an unknown person. This fear is unlikely to go off in this era with increasing prevalance of diseases like human immondeficiency virus infections (HIV). Sometimes the social embarrassment is also an issue in providing mouth-to-mouth breathing in a public place.
Cardiac only resuscitation
Cardiac only resuscitation is probably the only solution to improve the rates of resuscitation in public places. In cardiac only resuscitation, only chest compressions are given and no mouth-to-mouth breathing is given. Recent studies have shown that cardiac only resuscitation is not inferior to cardiopulmonary resuscitation. This is probably because chest compression itself can move some air in and out of the lungs, even without giving mouth-to-mouth respiration. COR is expected to become an accepted modality of resuscitation of cardiac arrest victims soon. This will certainly increase the number of individuals resuscitated in public places.