Friday, March 25, 2011

Know CPR

Imagine a family member or friend collapsed in front of you and wasn't moving or breathing. Would you know what to do? Could you help save his or her life? Novato resident Stacey Beltran knew what to do when her uncle Doug Briggs crumpled to the floor this past Christmas Eve. Fred Potter of Tiburon knew what to do when his good friend Steve Sears went down in January 2008. They called for help and started CPR.
Fifty years ago, the closed-chest resuscitation technique (the cardiac component of what is commonly known as CPR) was described by William Kouwenhoven in the Journal of the American Medical Association. Kouwenhoven and colleagues at Johns Hopkins reported a success rate of 70 percent - unheard of in those days - when using the technique to treat hospital patients suffering from sudden heart attack related arrest. The implications were immediate and widespread. "The closed-chest method replaced the 'ghastly' ritual of open cardiac massage (cutting through skin and bone to access the heart). No longer would resuscitation be limited to surgeons bold enough to wield a scalpel," wrote W. Bruce Fye in American Cardiology.

This year the technique of chest compressions combined with assisted respirations celebrates its 50-year anniversary. Since its adoption, CPR has become a staple of care for patients whose hearts have stopped and has been taught to thousands of health-care providers, first responders and citizens. Multiple studies have shown that CPR, particularly

when paired with early use of an electronic defibrillator, saves lives.
Consider a study of 1,667 patients with outside-the-hospital cardiac arrest in King County, Wash. In this group of patients, if CPR and defibrillation (or other advanced life support intervention) were started immediately, the patient had a 67 percent chance of survival.

For each minute that passed without these, the chance of survival dropped by 5.5 percent. Thus, 10 minutes after cardiac arrest, if nothing had been done, the survival odds were 12 percent. In another two to three minutes they were zero.

However, if CPR alone was performed (keeping blood flowing to the brain and vital organs while awaiting help), the odds improved by 2.3 percent a minute - essentially doubling survival at 10 minutes post-arrest.

But, statistics are just part of the story. Sears, owner of Sam's Anchor Cafe in Tiburon, is alive today because Potter started CPR. It was mid-afternoon on Jan. 17, 2008, and Sears was tending to the business side of his restaurant when he collapsed. "My heart had been racing all day," Sears told me. "I remember standing in my office. After that, I don't remember anything."

Potter, a retired engineer-paramedic with Tiburon Fire, was on the deck of Sam's showing his brother the view of the bay when he heard a commotion from inside. Potter handed his cup of coffee to his brother, rushed into the office and started CPR. "The adrenaline was definitely pumping," Potter told me. "I knew what to do, but it was the first time I'd ever had to do it on a good friend."

Moments later Tiburon Fire Battalion Chief Ed Lynch arrived with an automated external defibrillator (AED) - a life-saving device that Potter describes as "easier to use than a cell phone."

Briggs is alive today because his niece knew what to do. Beltran had just taken a course in CPR from Sandy Wargo of Novato Fire. After her sister dialed 911 and got a dispatcher on the line, Beltran put her CPR skills to use.

"All of a sudden, I remembered the steps in CPR É I looked at his chest, hoping for movement, and nothing É so I put my hands together, looked for the spot on his chest and started compressions. I counted aloud just like Sandy taught me to do."

Moments later, the Novato Fire paramedics were on scene and shocked Briggs' heart rhythm back to normal.

Sears and Briggs suffered heart attacks that caused a sudden alteration in heart rhythm called ventricular fibrillation. Both required stents to open coronary arteries and both were home and mostly recovered within a few weeks. They are exactly the type of people - relatively young (under 70) and relatively healthy - who are the best candidates to survive cardiac arrest. But their survival, and that of others like them, is predicated on immediate assistance.

So, would you know what to do? Would you be able to put aside emotion and do what was needed? Or would you just stand there? If you're not sure, there are steps you can take. First, you can sign up for a basic life support course. Second, you can pay attention to where AEDs are kept - you will notice them at the gym, on campus and at the airport. And finally, on June 4 you can come to one of multiple sites in Marin and celebrate CPR's 51st birthday by receiving free (noncertified) training in hands-only CPR and AED use. The training will take less than 10 minutes, and just might help you to save someone's life.

But, don't take my word for it. "It is extremely important," said Sears. "Because without training, people freak out É they don't have the confidence to know what to do. I was fortunate to be in a circumstance where people knew what to do. I hope that my story will motivate people to get out there and get trained."