Published on 14th October 2021
What can you do in a minute? Part boil a kettle. Put one shoe on and tie the laces. Save a life.
Did you know that for every minute that a person is in cardiac arrest without access to a defibrillator and CPR, their chance of survival drops by around 10%?
It doesn’t take a rocket scientist to work out that just a few minutes into cardiac arrest, the patient’s survival rate starts to plummet. Applying defibrillation within the first few minutes increases the chance of survival from 10% to 70%.
What is even more alarming is that the UK survival rate is significantly lower than many other countries – less than 1 in 10 people survive an out-of-hospital cardiac arrest, compared to countries such as Norway, where their survival rate is around 7 out of 10 people
What is the difference? Awareness of what to do – we’re not remotely CPR-ready so most UK citizens would not have the confidence to step up in those critical first few minutes.
One of the reasons that Sudden Cardiac Arrest is currently the biggest cause of death in the world is how it strikes. With no notice at all, and often completely undetected, chaotic electrical activity in the heart disrupts the heartbeat so much it stops beating abruptly and unexpectedly.
If you are a bystander when this happens, most of us wouldn’t know what to do, so the best thing you can do is to familiarise yourself with the following steps, and to understand that you could save somebody’s life simply by knowing how vital the first three steps are.
The six links in the chain of survival are:
The first three steps are where you can help. You may not realise that because of technological breakthroughs, many modern defibrillators such as the Lifeline View are so easy to use, that a completely untrained bystander such as a child could apply the defibrillation. Your job isn’t to wait for a trained medical professional anymore…
As with any emergency, the first step in the chain of survival is to assess the scene and call 999 for an ambulance. If the person has collapsed, there are three steps to take before applying CPR. Think of the acronym for Sudden Cardiac Arrest – SCA.
SAFETY – make sure the scene is safe for you to help, and if it is safe to proceed, kneel down next to them to check how responsive they are. Give a hard tap on their shoulders and shout “Are you ok, are you ok?” If they are in sudden cardiac arrest, they will be completely unresponsive and won’t respond to you yelling at them or hitting their torso.
CALL FOR HELP – Shout HELP! Get people’s attention and assign crucial lifesaving jobs straight away – one person to call emergency services, one to try and locate an AED, and a third person to go and wave the ambulance down when it arrives. Make it extremely clear who is in charge of each job. If you are on your own, call the ambulance, put your phone into speaker mode and listen to the instructions of the dispatcher as they will talk you through how to save a life!
AIR – are they breathing? Is their chest rising? You won’t need to perform CPR if their chest is moving up and down and you are confident they are breathing. If you are in any doubt at all though, there is a strong chance they need immediate CPR. They also need CPR if they are agonal gasping which sounds like a long drawn out breath, a snore, groan, or snort as this isn’t normal breathing.
To give a person in cardiac arrest the best possible chance of survival, CPR will need to start within 10 seconds of them collapsing.
CPR has two steps to it: chest compressions and breath. If you are not able to or uncomfortable giving breaths, giving “hands-only CPR” can still save a life which is why we will only focus on that.
Chest compressions are the most crucial part of giving CPR – called Hands-Only CPR, this means you are only performing chest compressions.
To perform CPR, you will need to kneel very close to the side of the person. They will ideally be lying on a HARD, FLAT surface on their back. Put one knee alongside their shoulder, your other knee in line with their waist and make sure you are positioned up and over the person’s body. CPR can tire you out very quickly so being able to use your body weight to help you push down on the chest compressions will help with this.
Place your hand, palm downwards in the middle of their chest on the breastbone. Take your other hand and clasp the two together so that they interlock. Push down on the middle of their chest hard and fast aiming for a rate of 100-120 compressions per minute.
Do not stop until the ambulance or AED arrives. Even if you have never tried CPR before, try it. This still significantly increases their chance of survival.
CPR is vital as it keeps blood flowing when the heart stops pumping so will buy some time for the person in cardiac arrest.
The reality is that in order to survive, the AED needs administering as soon as possible. Do not panic if you are on your own, or are untrained – AEDs will tell you what to do, step by step if they are like the Lifeline VIEW AED.
First of all, turn it on. The Lifeline will walk you through the following steps but here is an overview to help with your understanding, should you ever find yourself in this position.
Because the pads always need to be placed on bare skin, the AED will instruct you to remove their clothing.
The defibrillator pads will often have pictures on them, informing you where to place them. One needs placing on the right side of the chest, upright and under the collar bone. The other needs to be placed under the armpit, on the left side of the rib cage. There are different pads provided for adults and for pediatric patients aged eight years old or younger.
Note – if there are no pediatric pads available, you can still use adult pads on a child. Place one AED pad in the middle of their back between the shoulder blades and the other in the middle of their chest.
Once the pads are correctly in place, the machine will start to analyse the patient and inform you to “stand clear.” Ensure that NOBODY is touching the body, including yourself. If a shock is needed the device will instruct you to stand clear before it starts charging.
Once ready, it will give the instruction to press the shock button. Again, confirm that the body is completely clear of anyone else touching it before you push the shock button. Once you have pressed the shock button, the machine will advise you to start CPR if needed. The device has a metronome to guide the pace that CPR is administered.
After two minutes of CPR, the device will analyse the patient again before determining if a second shock is advised. The machine will continue to work in two minute cycles.