Gary Montague from HeartHero published this on another website....think about it and post your comments...
Despite the current Coronavirus pandemic, Cardiac Arrest has been a long standing epidemic that is not talked about. Six million people worldwide die every year due to Sudden Cardiac Arrest (SCA). 70% of all SCAs happen in the home, but the percentage will increase this year due to self-isolation and Shelter in Place. Those numbers are staggering when compared to the death toll of COVID-19. Recently, New York has seen an 800% increase in deaths occurring at home from SCA. Why? Because COVID-19 doesn’t just effects the lungs, it also puts your heart in jeopardy. Unfortunately, deaths from Cardiac Arrest will only continue to rise due to COVID-19’s cardiac effects as well as a decrease in people seeking treatment for Heart Attacks. The New York Times article, “Where Have All the Heart Attacks Gone?” reported a 40% decrease in chest pain complaints presenting to the hospital. There are likely more cardiac events happening now, but people are electing to stay home when they have chest pain due to COVID-19. Suffering a Heart Attack carries a 30% mortality rate and the subsequent damage puts you at greater risk for Cardiac Arrest in the long term.
Before COVID-19, the average EMS response time was 7–10 minutes which already results in a decreased chance of survival of SCA. For every minute that the heart goes without a shock from an Automated External Defibrillator (AED), a person’s chance of survival decreases by 10%. Now cities, including New York and Los Angeles, have experienced increased EMS response times (up to an hour in some locations), severely decreasing chances of survival from SCA. The pandemic has also resulted in some EMS agencies being instructed to not transport Cardiac Arrest patients to the hospital unless they get a pulse back at the scene.
Does CPR save lives in the event of Cardiac Arrest? Yes, but to what extent? If you watch TV or listen to the media, you would assume it is a lot. But in reality, survival rates average 7%, and might be as low as 2.9% for In-Home Cardiac Arrest.The American Heart Association (AHA) just released interim guidelines for addressing CPR in the COVID-19 era. It mainly focuses on professional rescue and in-hospital rescue but what about arrests that occur at home? The guidelines talk about “hands-only CPR” to prevent transmission of COVID-19 but does that completely protect bystanders? Every time you push on the chest you are compressing the lungs and thus expelling air. Is this person COVID-19 positive? Was this Cardiac Arrest a byproduct of the virus? Did you just put yourself and the surrounding people at risk?
If you have a loved one that has a Cardiac Arrest, CPR has been and should continue to be part of the solution but, did the AHA go far enough in addressing CPR in the COVID-19 era? Is directing people to do “hands-only CPR” the only answer to not put other people at risk? If ambulance response times are now greater than 10 minutes, is there another solution?
Is CPR dead? According to the Italian study, “Community-based Automated External Defibrillator Only Resuscitation for Out-of-Hospital Cardiac Arrest Patients”, the answer is POSSIBLY. This study emphasizes that focusing on early defibrillation only in Cardiac Arrest can lead to positive outcomes with 41% surviving SCA with a hospital discharge vs 6% for those that received CPR at any point. Defibrillation is effective. If the heart is shocked within the first minute of a Cardiac Arrest, there is a 90% chance at survival.
The industry currently focuses on public placement of AEDs, so they are not readily available in the home where the majority of Cardiac Arrests occur. Combined with increasing EMS response times, there will be an increase in deaths from Cardiac Arrest in the COVID-19 era. COVID-19 might be the impetus the industry needs to move forward in its approach to SCA.
As those on the frontlines are overwhelmed during the COVID-19 outbreak, we must empower the public to treat SCA. Now is the time to challenge the industry to do better, to innovate, and to address the problem of Cardiac Arrest. The answer is looking beyond CPR and having AEDs where they need to be, in the home. Giving families the power to treat SCA may be the key to treating Cardiac Arrest in the COVID-19 era and beyond.
Gary Montague PA-C
Last edited by Dan Mohrbacher; 04/19/2020 3:50 AM. Reason: Clarification of attribution