Timothy M. Satty, MD, assistant professor of emergency medicine at Rutgers New Jersey Medical School and medical director of emergency medical services at University Hospital in Newark, New Jersey.
When 25-year-old Buffalo Bills football player Damar Hamlin went into cardiac arrest after a play on the field, his life was saved by the quick reaction of Denny Kellington, one of the team’s assistant athletic trainers. Kellington stepped up and performed cardiopulmonary resuscitation (CPR) and used a defibrillator—on national television.
As shocking as it was to see an athlete in prime physical condition collapse, many people of all ages, even young children, unexpectedly go into cardiac arrest every day—indeed, it happens to 350,000 Americans a year, according to the American Heart Association. And 70 percent of the time, it happens at home. Survival depends on someone stepping forward in the time it takes for emergency responders to arrive. That someone could be you.
You might be surprised to learn that it doesn’t involve complex medical training to learn CPR and possibly save the life of a stranger or of a loved one during this medical emergency.
Cardiac arrest and myocardial infarction (or heart attack) are two heart-related events that are often confused. With cardiac arrest, which often occurs out of the blue, the heart stops working. It stops pumping blood to the rest of the body, the brain included, which can quickly lead to organ death. A heart attack or a blockage is one cause of cardiac arrest. There can also be an electrical problem within the workings of the heart due to any number of issues, such as blunt trauma (if someone gets hit in the chest at a specific moment in the heart’s electrical cycle, it can cause a short circuit), a problem with electrolyte levels, or a drug overdose, to name just a few. Cardiac arrest isn’t a disease, but rather a symptom of an underlying problem. If someone suddenly collapses and is unresponsive, there’s a strong possibility of cardiac arrest, and CPR is needed as a stopgap measure until the heart can pump on its own.
A heart attack occurs when there’s a blockage of an artery or blood vessel and the heart doesn’t get enough oxygenated blood. This causes symptoms such as chest pain that might radiate to the shoulder and neck and trouble breathing. It too requires immediate action by calling 911. But heart attack victims are often still able to talk. CPR is needed only if the person is unconscious.
When someone is in cardiac arrest, the goal is to resuscitate or restart the heart as soon as possible. CPR should begin immediately after calling 911 and, when available, an automated external defibrillator (AED) should be used quickly. An AED is a small device that can analyze the heart’s rhythms and deliver appropriate electric shocks to get the heart back on track.
Without these measures, survival is less likely. Immediate CPR and the use of an AED can double or triple chances of survival after cardiac arrest because these measures can keep the heart going until medical personnel arrive. Note: If possible, one person should call 911 while another starts CPR and then activates the AED as CPR continues. Know that 911 dispatchers are trained to walk callers through the correct procedures while you wait for the EMTs.
Many people still think of CPR as giving “mouth-to-mouth,” but we now know that action has limited value, and that it also makes people less willing to do it. Compression-only CPR, or hands-only CPR compression, is now what’s recommended. Your hands do the work of the heart to keep blood flowing: With both your hands on the center of the person’s chest, you press hard and fast, at the rate of about 100 to 120 times a minute (about the tempo of the song “Stayin’ Alive” by the Bee Gees) with minimal, if any, stopping unless prompted by the AED until EMTs arrive. If you’re not familiar with that song, other songs that can keep you in time include “Cecilia” by Simon and Garfunkel, “Superstition” by Stevie Wonder, and “December 1963 (Oh What a Night)” by Frankie Valli.
AEDs can now be found in many public places like schools, athletic fields, stadiums, restaurants and airports. The goal is to get them everywhere large groups of people congregate. If, for instance, you volunteer at a large meeting place or attend religious services at a congregation that doesn’t yet have an accessible AED, talk to those in charge about getting one. There are also home models available.
A portable defibrillator is extremely easy to use because it was designed for people without medical training. As soon as you open its case and press the start button, voice prompts walk you through every step. Inside you’ll find self-sticking pads with pictures of exactly where to place them on the person’s body. As soon as information is transmitted via electrodes in the pads and analyzed by the computer within the AED, you’ll hear voice prompts to press a button to deliver an electrical shock, if needed, and when to pause and restart CPR.
Everyone can and should learn CPR. While people of any age are susceptible to cardiac arrest, as people age and develop certain chronic conditions, their risk increases. So, knowing CPR can be a lifesaver for those close to you. Fully virtual first aid classes are available. However, taking an in-person class can give you a greater sense of confidence. You’ll be able to feel the correct hand placement and the timing and depth of chest compressions. You’ll also get familiar with how an AED works.
CPR training doesn’t take a lot of time. The American Heart Association and American Red Cross have courses that can be completed in a few hours, and there are many options available, making it easy to find a class that fits your schedule.
A sudden collapse is the first sign of cardiac arrest. You’re likely to also see that the person:
Cardiac arrest might look like fainting. But when most people faint, they continue to breathe and will come around relatively quickly, often within seconds. That’s not the case with cardiac arrest. Also, it’s no longer suggested that bystanders try taking the person’s pulse—you’re in a high-adrenaline situation and this measurement can be unreliable. Err on the side of caution: If someone collapses, it’s better to start CPR and find out later if it wasn’t needed rather than delay CPR and risk the person dying.
IMPORTANT: Don’t be reluctant to perform CPR on a woman. Studies have found that women in cardiac arrest are less likely to be given CPR by a bystander because the bystander feels awkward about placing their hands on a woman’s chest or could be looked at suspiciously. But when someone, man or woman, is in cardiac arrest, there are no higher life-and-death stakes. Trying to save a life will never be viewed as inappropriate.