The world awakes to the importance of acting fast in an emergency. Millions of horrified onlookers saw the dramatic scenes unfold on 12th June at the Euros; as we sat eating BBQ’s or having drinks with friends, we saw a young man suffer sudden cardiac arrest (SCA). We all agreed, the BBC should stop the footage, but most of us carried on watching, hoping, and praying that the player pulled through. As horrible as it was to watch, we saw quick thinking and fast response to an emergency. Ultimately, we learnt the importance of acting quickly in an emergency.
Since the incident, I have spoken to many people about what we saw, and there seems to be a running theme. “I cannot believe how quickly he went from running around to needing CPR”. CPR is short for Cardio Pulmonary Resuscitation. Unfortunately, SCA is more common than we all think. Let’s look at some statistics:
- Approximately 30,000 people each year require resuscitation from the ambulance service.
- Cardiac arrests at home account for 72% and 15% in the workplace.
- 7 in 10 cardiac arrest cases has a bystander attempt CPR.
- Less than 1 in10 out of hospital cardiac arrest cases uses a public defibrillator.
- 98% of cardiac arrest cases occur in adults, and 33% of these people were between 15 and 64.
- The average response time for an ambulance is 6.9 minutes.
What is SCA?
Sudden Cardiac Arrest is when the heart stops suddenly, meaning your heart cannot pump oxygen around the body. Without oxygen, damage to the brain can occur in as little as 3 minutes, and with every minute that passes after that, the damage becomes more severe.
If you have ever watched an episode of Casualty, then you have possibly heard somebody shout, “they have gone into VF”. Then, you will see the team rush to the patient with the defibrillator and begin CPR. VF stands for Ventricular Fibrillation (VF). This is an abnormal heart rhythm caused when the heart’s electrical activity becomes so disorganised that it stops pumping blood around the body. VF is a significant cause of sudden cardiac arrest.
So why are training and time so necessary?
Training is where you save time. A person who has had training will still hesitate, and if I am honest, they will forget everything they know for a split second. Forgetting is normal. But also is why training is so important! Once that initial freeze is over, you will have a pool of knowledge to come flooding back to you. Understandably, an untrained person may hesitate for longer and possibly even not be confident enough to help at all.
At the Euros, we saw a well-oiled machine, and in my opinion, that was the most prominent part in the player surviving. To my knowledge, the player was still breathing when the medical staff arrived. This meant they had all the equipment needed to treat him when his heart stopped. Additionally, very little to zero time was wasted. He was given CPR and, according to news reports, one shock with a defibrillator. After that, he began to regain consciousness. This is amazing but also unrealistic in most of our lives.
When you look at the time above, the ambulance is 6.9 minutes away at its best; the person would have to have been found before an ambulance was even called. Think of your workplace or your home. How long could you be missing before anyone come looking for you? Let’s be generous and say you will be found within 5 minutes; if CPR is not started immediately, then you have been 11.9 minutes without oxygen going around the body.
Remember, damage to the brain begins approximately 3 minutes from when oxygen stops being pumped around the body.
A trained first aider should know to start with DRAB, Danger, Response, Airway, Breathing. They will know to call a bystander for help and ask them to contact the emergency services. But, if a bystander is not available, they can always phone the emergency services themselves using a mobile phone on loudspeaker. Whilst doing this, they can commence CPR, which means blood is now being manually pushed around the body, delivering oxygen to the brain. Therefore, giving a better chance of survival when the emergency services or defibrillator arrives.
Once the defibrillator arrives, it’s essential to set the defibrillator up and have it ready for use. Yes, the defibrillator will tell you what to do. But again you cannot beat training for building your speed and confidence. Even in the training room, using a training defibrillator that does not shock. Some candidates do not want to press the shock button as they are afraid of the unknown. Imagine a person like this in real life and no training. In the training room, some candidates will initially place the pads in the wrong place. Once it has been explained to them that pictures show you how to set the pads, the mistake goes away, and the time from the first go with no training to the second go with training is greatly improved. This can only be of benefit to the patient.
Does your workplace or community have a defibrillator, or do you know where your nearest defibrillator is? Some communities have defibrillators positioned around the neighbourhood, often in old phone boxes or outside sweetshops. Local shopping centres, sporting facilities, any place where a gathering of large groups will tend to have a defibrillator.
When you call 999 or 112, you must state you are going to start CPR. If a defibrillator is within easy distance, the call handler will tell you the location, and then you can send someone to get the machine whilst you continue CPR. When the machine arrives, switch it on and either follow the prompts or your training. Try and get the helper to either place the pads under your supervision or take over the CPR whilst you set the machine up. When set up, follow the instructions and keep going.
How do I know if CPR is needed?
CPR is required when the patient stops breathing, and the heart stops pumping. Start by checking for Danger to yourself and the patient. Then continually talk to them, looking for a Response. If they are not responding, call for help, then look inside the mouth for obstructions but do not put your finger in to feel for obstructions.
If the mouth is clear, use the head tilt chin lift manoeuvre by placing the palm of your hand on their head, like a parent would do to a child with a temperature. On your other hand, you make a gun shape from your thumb, index, and middle fingers, place them on the chin, tilt the head back, place your ear over the mouth to feel for breath, and look down the chest to see signs of normal breathing. You should do this for up to 10 seconds.
At this point, if there is no sign of life, then get help and start CPR. Always follow the instructions of the call handler from 999 or 112. You need to deliver chest compressions and breaths at a rate of 30 breaths to 2 compressions (30:2) at a speed of 100 to 120 presses per minute and for an adult at a depth of 5 to 6 cms.
I must stress follow the directions of the call handler. If you have not had training, unwilling, or do not have a face shield or proper protection, simply deliver chest compressions without breath. You should continue this until emergency help arrives, they wake up, you are so tired you are going to pass out. If you feel you will pass out, you can train a bystander to deliver compressions. Where possible, we recommend to swap rescuers every 2 minutes due to fatigue.
What is the difference between SCA and a Heart attack?
As mentioned above, Sudden Cardiac Arrest is where the heart stops pumping blood and oxygen around the body. A heart attack is where there is a blockage in the heart’s arteries, but blood is still pumping around the body, and the patient would be breathing. Be aware that a heart attack can lead to SCA.
It is crucial to act quickly by calling the emergency services and sitting the patient in the lazy ‘W’ position with a heart attack. Sit them down with their back against a wall and bend their knees so their feet are flat against the floor. This will help slow the blood flow back to the heart. Make sure you follow instructions from the call handler at the time.
Make sure to promote self-care!
We all hope we are never in a position where we need these skills. But sometimes, we find ourselves in these situations. When the dust settles, and you are on your own, take time to process what you have been through, talk about your experience to friends, family and colleagues.
If needed, talk to a doctor or other professional. Dealing with SCA can be a very traumatic time and can affect the first aiders mental health. You have looked after the patient; now take the time to look after yourself.
For more tips and advice on what happens after you have been involved in a first aid emergency, read our other blog here.
Concluding thoughts…
The end of the blog is upon us, and I hope you can see why time and training is so important. What we all witnessed the other day will stay with us forever. The emotion of it happening and the feeling of happiness when he pulled through. This was all possible due to training and time.
Therefore, Altta Group Limited would like to offer FREE AED training to any local community with an AED (Automated External Defibrillator). Spaces will be limited to a maximum of 100 places in total and 5 per community, so please get in quick. To qualify, we will need the make and model of the AED you have, and you must be able to attend the training session at our training centre in Orton Southgate at your given time. Times will be evenings or weekend mornings.
Please share the post to help more communities complete first aid training.
For more information, please call 01733237115 or email info@altta.co.uk.
Or follow this link: https://youtu.be/7lMiXJH_bw4 for an instruction video on CPR.
Written by Colin Frost (Instructor at Altta).
