Page 66 - Occupational Health & Safety, October 2018

DEFIBRILLATORS & CPR
Squad Goals: Moving the Needle on
Sudden Cardiac Arrest Requires a New Model
A volunteer “SCA responder squad” is needed to ensure someone is almost always nearby who feels ready and willing to help.
BY RICHARD A. LAZAR
Sudden cardiac arrest (SCA) is the third- leading cause of death in the United States and, for many reasons, one of the most challenging public health issues for our na- tion. According to a recent National Academy of Sci- ences Institute of Medicine study, upwards of 395,000 people experience SCA outside of hospitals each year in the United States, equivalent to the popula- tion of New Orleans. But nationally, despite decades of awareness initiatives, preventative programs, and treatment innovations, less than 6 percent of these people survive, a frightening number that hasn’t changed in 30 years. That’s why it’s time for an “SCA response squad” model.
The medicine of SCA is well known. It is the abrupt loss of heart function that most often occurs when the electrical impulses in the heart become cha- otic (known as ventricular fibrillation), causing it to suddenly stop beating normally. The condition is 100 percent fatal if not treated quickly.
And SCA is very much a treatable condition. Two therapies—cardiopulmonary resuscitation (CPR) and defibrillation—delivered in the first minutes after
SCA occurs can have a profound impact on survival. The faster CPR and AED use happen, the higher the chances of survival. Unfortunately, this help rarely ar- rives in time. Here are some of the reasons why.
■ Lack of public awareness and understanding of what SCA truly is—and what it isn’t: Nearly 50 years after coming to public consciousness, both the media and the public still often confuse sudden car- diac arrest (a cardiac electrical problem, which can be helped by timely bystander CPR and AED use) and a “heart attack” (a cardiac plumbing problem that causes inadequate flow of oxygen-rich blood to the heart, which requires the intervention of medical profes- sionals). This confusion makes potential bystanders unclear on what can and should be done.
■ Low bystander CPR rate: Over the past 30 years, billions of dollars have been spent formally training millions of people in CPR. Yet, only about 26 percent of SCA victims receive bystander CPR today. Factors contributing to persistently low CPR rates in- clude lack of awareness about SCA and how to help, lack of confidence in the ability to help, fear that try- ing to help will make the person’s condition worse,
62 Occupational Health & Safety | OCTOBER 2018
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