Posted on 06/15/2021
Kelly N. Sawyer, MD, MS
Kelly N. Sawyer, MD, MS

The world watched last Saturday as Danish soccer player Christian Eriksen suffered a sudden cardiac arrest on the field during the Euro 2020 tournament. The quick action of his teammates, doctors and first responders who performed cardiopulmonary resuscitation (CPR) on Eriksen immediately, and, then used an automated external defibrillator (AED) to shock his heart back into rhythm are vital links in the “Chain of Survival,” a useful metaphor for the elements of the emergency cardiovascular care systems concept; a strong Chain of Survival can improve chances of survival and recovery for victims of cardiac arrest. 

More people are surviving cardiac arrest because of CPR being performed quickly; survival rates can double or triple if CPR is performed within the first few minutes of cardiac arrest[1]. However, systems of care after the patient leaves the hospital, when many sudden cardiac arrest survivors are known to suffer from physical, cognitive and emotional problems, are lacking and need to be addressed, according to the Sudden Cardiac Arrest Survivorship scientific statement by the American Heart Association, a global force for longer, healthier lives. 

“Patients, families, caregivers, health care providers, prehospital providers and lay rescuers might struggle with symptoms of anxiety, depression, and post-traumatic stress after performing, watching or being resuscitated,” said statement author Kelly N. Sawyer, M.D., M.S., American Heart Association volunteer and assistant professor of emergency medicine at the University of Pittsburgh School of Medicine in Pittsburgh, Penn. “Survival after cardiac arrest is complex and requires long-term support. Healthcare partners and community leaders can provide survivors, their families and rescuers the opportunities to not only share their stories, but also add their voices as powerful advocates for CPR training, AED use and general cardiac arrest awareness.” 

With this in mind, a new recovery link has been added to the Chain of Survival, which emphasizes physical, social, and emotional needs of patients and their caregivers after survivors leave the hospital, according to the 2020 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care

“Survivorship is a journey that starts with the sudden cardiac arrest and includes at least the first 12 months thereafter,” Sawyer said. “Post cardiac arrest care is multi-disciplinary and requires coordination so that it does not end when patients are discharged from the hospital.” 

Tips for recovery for cardiac arrest patients include: 

  • Structured assessment for anxiety, depression, posttraumatic stress, and fatigue for survivors and their caregivers. 
  • Rehabilitation assessment and treatment for physical, neurologic, cardiopulmonary, and cognitive impairments before discharge from the hospital. 
  • Comprehensive, multidisciplinary discharge planning for cardiac arrest survivors and their caregivers, including medical and rehabilitative treatment recommendations and return to activity/work expectations. 

Stories like Eriksen’s are why the American Heart Association advocates for early CPR education in the community in schools, sports and for bystanders. Learning the quick and simple steps to Hands-Only CPR is one of the best ways bystanders can be prepared for an emergency. 

SOURCE: American Heart Association

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