If people listen to Dr. George Lundberg, it will be very unfortunate for future victims of sudden cardiac arrest.
He states in MedPage Today, "If an average adult keels over in the street, is found unresponsive and pulseless by a bystander, and is administered CPR while a 911 call is made, the odds that such a person will emerge from the eventualities of the resuscitation effort healthy and with a normally functioning brain are about 2%." The other outcomes are death -- soon, or within 30 days -- after lots of cost and much suffering for many, or being discharged from a hospital, alive but mentally impaired, presumably lifelong. So, I don't know about you, but if I drop dead on the street, observed or unobserved, I suppose the observer will feel obligated to call 911, but PLEASE do not administer closed chest cardiac massage to me." More...
Seriously? As noted here, we state: "Sudden Cardiac Arrest affects about 1,000 people a day. Imagine two 747s crashing every day and you will get an idea of its toll. However, while the average survival rate is 8%, communities with strong layperson CPR programs and ready access to automated external defibrillators (AEDs) have achieved survival rates of 38% and higher. The Sudden Cardiac Arrest Foundation has a growing community of survivors -- people of all ages who were brought back to life -- and to their families, thanks to immediate intervention by bystanders. Check out our website, www.sca-aware.org, and you can see for yourself the profound lifesaving benefits of training the public in CPR and use of AEDs."
-Mary Newman
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The doctor's wishes...
fwiw, here's what ran through my mind as I read the doctor's remarks:
1. If he doesn't wear a DNR bracelet, he is being insincere. If he is wearing one, that's his right.
2. It's been a while since he reviewed the statistics: the odds of getting out of the hospital, post-arrest, with major brain function intact vary tremendously: If you arrest on a farm, the odds approach 0%. If you arrest in the Phoenix Airport, the odds are 75%. If you arrest at home - which is where 2/3 of all arrests happen in the USA, the odds are 2% for all arrests at home and 4% for all witnessed arrests at home. (...and there is a lot of fuzz on the definition of 'unwitnessed' because a lot of people don't know how to spot a cardiac arrest when they see one. I can't recall how many times I've heard a dead person's spouse say "He/she gasped once or twice during the night - I thought it was sleep apnea or a bad dream - and when I woke up he/she was cold.)
There is a great deal of variability in outcome. Phoenix's 75% save rate is an average they have achieved for ten years! The existence of such a wide variability in outcomes indicates rather convincingly that some folks are doing something right, and some folks are not.
Based upon my four years in the ER and eight years on the ambulance, the neurological impairment problem appears to be greatest when nobody does anything until the ambulance arrives or interrupts CPR for more than a few seconds or doesn't push the chest deeply enough or pushes too slowly.
My wife and I have an AED at home, and we travel with it, too. We're both current in our CPR skills, and when using the heel method can both do compressions of at least 2" at a rate of 100 per minute for more than ten minutes. We're not bashful about urging others to get trained and to get an AED for personal use. There's a 35 minute video at www.slicc.org (click on the "For Past Trainees" link in the left column) that will teach you CPR, AED use, the Heimlich maneuver, and stroke recognition. You really need to have those people you spend time with watch the video...and they need to have you watch it, too.
AED
Ventricular fibrillation (V-Fib) is the most common reason for unexpected death in victims. In this condition the heart of the victim stops beating and to the treatment for this is to give electrical shock to the patient but, it is necessary that the shock should be given within less than four to six minutes, to save the life of the victim and so that the damage to brain should also be minimized as in such situations there is lack of blood and oxygen supply. Automatic external defibrillators (AEDs) are commonly used at all the public places to treat people suffering from sudden cardiac arrest.