DNP Student: Cardiovascular Thoughts

Post 2

Hello again. Like I promised I am back to talk about barriers to bystander CPR, how you can learn CPR, and what other tools might be out there!

Barriers to bystander CPR

The first barrier to bystander CPR is knowledge. A survey reported by the Cleveland Clinic found that only 54% of Americans know CPR, only 1 in 6 know about the most recent recommendations of compressions only CPR for bystanders, and just 11% knew the proper rate for compressions (Cleveland Clinic, 2017).
Other barriers noted during a study done in 2016 included fear of litigation, fear of catching a disease, and fear of either performing CPR wrong and hurting someone or performing it when not necessary and hurting someone. The study also found that training and education were important factors in reducing these barriers (Bouland, et al., 2017).
Training is the solution to overcoming barriers to bystander CPR

How you can learn CPR

Go to the experts. While there are several organizations that offer bystander CPR classes, I recommend going through the American Heart Association if possible. This is the same organization that trains and certifies health care professionals.
Visit their website for possible classes online and in your area.
https://cpr.heart.org/en/courses/heartsaver-first-aid-cpr-aed-course-options

What other tools are out there?

Smartphone Apps: There are apps like pocketCPR, that provide feedback for performers of CPR. These apps have been shown to improve compression rate, hand position and minimizing of no-flow time. Studies did not show any improvement in depths of compression when using these devices (Plata, et al., 2019).

I encourage everyone out there to learn CPR, you could be the difference that gives someone a second chance at life.

References
Plata, C., Stolz, M., Warnecke, T., Wetsch, W., Bottiger, B., & Spelton, O. (2019). Using a smartphone application (PocketCPR) to determine CPR quality in a bystander CPR scenario. Simulation and Education. Published. https://doi.org/10.1016/j.resuscitation.2019.01.039
Miller, K. (2019, January 17). New Cleveland Clinic Survey: Only Half Of Americans Say They Know CPR. Cleveland Clinic Newsroom. https://newsroom.clevelandclinic.org/2018/02/01/new-cleveland-clinic-survey-only-half-of-americans-say-they-know-cpr/

Heartsaver® First Aid CPR AED Course Options Explore your options for training in first aid, CPR and AED from the American Heart Association and sign up to take a class today!

Post 1

I want to talk about how important bystander CPR is.

I work in the cardiac cath lab. Our primary purpose is to provide life saving care to heart attack patients. One of the ways we do this is by opening blocked coronary arteries, the blood vessels that supply blood to the heart. The other day my team and I were called in to the hospital to treat a heart attack victim that had coded in the field. He had been found down and unresponsive; emergency services were activated. When the paramedics arrived they performed CPR, intubated the patient, and brought him to the hospital. We quickly took him to the cath lab and were able to open up the blockages in his heart arteries and transferred him to the ICU. Unfortunately because no CPR was done from the time he was found to the time EMS arrived (about 5 minutes), the patient went without oxygen for too long and it doesn’t look like he will wake up, even though blood flow was restored to his heart and his vital signs stabilized.

In the cath lab we have a saying that we hold dear to our heart (pun intended), “Time is muscle.” This is a way of saying that the longer you wait to treat someone who is having a heart attack, the more damage can be done to the heart muscle and the less likely recovery becomes. So everything we do in the cath lab when someone comes in having a heart attack is done with a high sense of urgency.

This sense of urgency should begin before the patient even reaches the cath lab. It applies to the ER nurses and doctors that receive the patient; to the paramedics and first responders who bring the patient to the hospital; and to the friends, family members, or even strangers who find the coding individual.

The American Heart Association talks about the out-of-hospital chain of survival. The first three links rely on the knowledge and participation of non-health professional bystanders; activation of emergency response, high quality CPR, and AED. When there is a lack of knowledge or willingness to act it weakens the chain because as everyone knows, a chain is only as strong as its weakest link (AHA, 2021).

Studies show that the risks of brain damage, nursing home admission, and death are all lower when bystander CPR is performed (Kragholm, et al., 2017).

If the man that I took care of earlier in the week had received CPR from one of the onlookers while they waited for the ambulance to arrive, then the patient might have made it to that final link in the chain: recovery.

Please check out my next post on what the barriers are to bystander CPR, how you can learn CPR, and what other tools may be out there to help.

References
Kragholm, K., Wissenberg, M., Mortensen, R. N., Hansen, S. M., Malta Hansen, C., Thorsteinsson, K., Rajan, S., Lippert, F., Folke, F., Gislason, G., Køber, L., Fonager, K., Jensen, S. E., Gerds, T. A., Torp-Pedersen, C., & Rasmussen, B. S. (2017). Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest. The New England journal of medicine, 376(18), 1737–1747. https://doi.org/10.1056/NEJMoa1601891Out-of-hospital

Chain of Survival. (2021). Cpr.Heart.Org.
https://cpr.heart.org/en/resources/cpr-facts-and-stats/out-of-hospital-chain-of-survival