When you see a cardiac arrest, your brain fights you - "No, this isn't really happening" - and the circumstances fight you - "Dang! in CPR class the manikin didn't weigh very much and wasn't sitting in a deep chair. This blog deals with practical details and presents reports of "saves." Let me have your questions and comments - they will steer the course of this blog.
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The precise incidence of SCA is unknown because available epidemiological databases do not record deaths due to sudden cardiac arrests. Therefore estimates are based on surrogate data. Efforts are underway to establish a better way to capture accurate data.
Each year in the U.S., 400,000 to 460,000 people die of unexpected sudden cardiac death in an emergency department or before reaching a hospital. (Circulation 2001;104:2158-63)
The age-adjusted sudden cardiac death rate is higher among men than women. (MMWR Feb 15, 2002 51(06):123-6).
Blacks have the highest age-adjusted rate of sudden cardiac death, followed by whites. (MMWR Feb 15, 2002 51(06):123-6).
States with a high proportion of sudden cardiac deaths, in descending order, include: Wisconsin, Idaho, Utah, Colorado, Oregon, Connecticut, Rhode Island, South Dakota, Montana and Vermont. Hawaii has the lowest age-adjusted sudden cardiac death rate; Mississippi has the highest. (MMWR Feb 15, 2002 51(06):123-6).
About two-thirds of unexpected cardiac deaths occur without prior indication of heart disease. (J Am Coll Cardiol 2004;44:1268-3008-13)
About 60 percent of unexpected cardiac deaths are treated by emergency medical services (EMS). (JAMA 2002;288:3008-13)
EMS treats about 100,000 to 250,000 cardiac arrests in the U.S. annually. (JAMA 2002;288:3008-13; Ann Emerg Med 1999;34:517-25)
Of the cardiac arrests treated by EMS, 20 to 38 percent are found in ventricular fibrillation (VF) or ventricular tachycardia (VT) (21,000 to 91,000 cases), rhythms that can be treated with defibrillators. (Ann Emerg Med 1999;34:517-25)
The incidence of VF is decreasing over time. (Ann Emerg Med 1999;34:517-25, Resuscitation 2004:63(1):17-24; Resuscitation 2005;67(1):51-4)
Fifty-seven percent of adults in the U.S. say they have undergone training in cardiopulmonary resuscitation (CPR), most often due to work or school requirements. Most say they would be willing to use CPR to help a stranger. Most say they would be willing to use an automated external defibrillator (AED). Eleven percent say they have used CPR in an actual emergency. (Resuscitation 2000)
The incidence of lay responder defibrillation was 2.05 percent in 2002. (American Heart Association)
The incidence of SCA in children is unknown. Estimates vary widely. Research among high school athletes suggests the incidence ranges from 0.28 to 1.0 death per 100,000 high school athletes nationwide (J Am Coll Cardiol 1998:32:1881-4).
The average survival SCA survival rate is 6-7%. (Prehosp Emerg Care 1997; 1(1):45-57.)