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Thursday, June 2, 2011

Interesting quiz, with answers...

A lot of people confuse heart attacks with cardiac arrest. Most heart attack victims don't die. Most cardiac arrest victims stay dead when they arrest.

There is a lot of folklore in circulation, most of which is incorrect. There is an interesting "What do you know about heart attacks?" quiz at

Cardiac arrests are a lot simpler: tens of millions of people have Coronary Artery Disease in North America. For more than half, the first symptom they experience is death.

Of these people who arrest, a 'theoretical maximum' of two thirds can be saved, if chest compressions begin immediately and defibrillation happens promptly. Unfortunately, this doesn't happen most of the time, because most of our population doesn't know how to recognize when someone needs CPR, doesn't know how to perform it, and doesn't have an AED (automatic external defibrillator) nearby when they witness a sudden cardiac arrest.

Take the quiz. Then watch the SLICC class video at and take it again.



Art Couldn't have said it better...

Bystander CPR: The biggest links in the chain of survival
Educating bystanders on basic life-support techniques presents a huge opportunity for improving survival rates

By Art Hsieh

The release of the American Heart Association 2010 Emergency Cardiac Care Guidelines marks the 50th anniversary of CPR. It is perhaps with some irony that some of the biggest changes in the resuscitation guidelines have occurred at the most basic level of care – public participation in managing sudden cardiac arrest (SCA). It may be that the greatest opportunity for EMS providers to improve patient survival from SCA is in the encouragement and support of the lay person to recognize cardiac arrest, activate the emergency response system, and perform effective chest compressions and defibrillation.

Scope of the problem
Approximately 350,000 people each year in the United States and Canada experience SCA and undergo resuscitation efforts1. Approximately half occur outside of the hospital. Despite 50 years of understanding the causes of sudden death and developing techniques to reverse it, out-of-hospital survival rates remain low, ranging from 3 to 16 percent in one multi-system study2. In another words, survival from out-of-hospital cardiac arrest has not improved significantly in decades.

Professional resuscitation comes of age
It has become apparent that the "professional" side of cardiac resuscitation has come of age. The number of medications that are routinely recommended for cardiac arrest management has been reduced, and advanced medical procedures such as endotracheal intubation has not been shown to reliably improve survival outcome.

This evolution is reflected in the 2010 Advanced Cardiac Life Support Guidelines; there have been relatively few changes in the recommended care provided by the advanced healthcare provider. The AHA has clearly organized its resuscitation guidelines around the delivery of high quality chest compressions to increase perfusion through the coronary arteries and the need to defibrillate early in cases of ventricular fibrillation. This makes sense – there is no reason to believe that the ALS "house" would stand if the BLS "foundation" is weak.

The effect of bystander participation
If the above statement is to be believed, then the greatest opportunity to improve survival is to turn to the first three links in the chain of survival: early recognition and activation, early CPR, and early defibrillation. In its executive summary of the 2010 Guidelines, the AHA states that, for the management of cardiac arrest "no initial intervention can be delivered to the victim of cardiac arrest unless bystanders are ready, willing, and able to act."3 Recent studies show that the sooner the CPR begins during cardiac arrest, the better the outcome.4,5

Where EMS plays a role
Prehospital care providers own the fourth link in the chain of survival in the out-of-hospital cardiac arrest. We are portrayed as heroes in television shows, movies, and newspaper reports when someone survives after a cardiac arrest. It is critical that the profession plays its part in getting the public to participate in the saving of a life.

While providing certification courses in CPR, AED and First Aid is helpful, there are additional ways to increase public knowledge of CPR. The AHA has endorsed the concept of "hands only" CPR, where recognition of cardiac arrest, activation of the emergency response system, and high quality chest compressions are the key knowledge points.

A casebook example of public participation would be the San Francisco Paramedic Association sponsorship of "sidewalk CPR," which began two years ago. During National CPR & AED Awareness week, volunteer instructors coaxed and cajoled people passing by the SFPA’s building during rush hour, and encouraged them to spend less than 5 minutes practicing hands only CPR on manikins that were laid out on the sidewalk.

Music such as the Bee Gee’s "Staying Alive," "Quit Playing Games with my Heart" by the Back Street Boys, and "Rock It" by Master P provided a soundtrack that allowed participants to practice a rate of about 100 beats per minute. Over the course of two hours, more than 50 individuals stopped and practiced CPR. The cost was low, and the fun factor was high. Last year the event expanded to San Francisco City Hall, where more than one hundred individuals trained during a short period.

EMS providers play a pivotal role in educating and encouraging their community in the management of cardiac arrest management. The level of respect and expectation from the public places us in a unique position to provide the leadership necessary to improve survival from cardiac arrest.


1. Lloyd-Jones D et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation. 2010;121:e46–e215.

2. Nichol G, Thomas E, Callaway CW, Hedges J, Powell JL, Aufderheide TP, Rea T, Lowe R, Brown T, Dreyer J, Davis D, Idris A, Stiell I. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300:1423–1431.

3. Field, et al. Part 1: Executive Summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122;S640-S656.

4. Yoneomoto N. The Effect of Time to Bystander Cardiopulmonary Resuscitation on Survival From Out-of-hospital Cardiac Arrest From All-Japan Utstein Registry Data: A Validation of 3-Phase Sensitive Model. Circulation 2010;122:A260.

5. Bobrow B et al. Chest Compression–Only CPR by Lay Rescuers and Survival From Out-of-Hospital Cardiac Arrest. JAMA 2010;304(13):1447-1454.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P is the Chief Executive Officer of the San Francisco Paramedic Association. In the profession since 1982, Art has worked as a line medic and chief officer in both third service and fire-based EMS. He has directed both primary and EMS continuing education programs. A Past President of the National Association of EMS Educators, and a scholarship recipient of the American Society of Association Executives, Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at

Now, THAT's a Program!

June 01, 2011 13:00 ET

Canadian Youth Learning CPR in the Tens of Thousands-and Saving Lives!

School's out for the summer and over 250,000 more youth have been trained in CPR this year!

OTTAWA, ONTARIO--(Marketwire - June 1, 2011) -

Editors Note: There is a photo and a video associated with this press release.

Students across Canada are celebrating the end of the school year. Also cause to celebrate is the fact that 250,000 more high school students have been trained in CPR this year. They will bring lifesaving skills to their communities this summer. The Advanced Coronary Treatment (ACT) Foundation is the organization that is setting up in-house CPR programs for high schools right across Canada.

Many lives are being saved and youth are confidently putting their skills to use in the face of emergencies.

Ninteen-year-old York University student Samantha Hunt is just one example. While relaxing at home after a week of demanding class work, she heard a loud crashing sound in the next room and heard her roommate Taylor yelling, "Call 911, Dylan collapsed!"

Trying to remain calm, Samantha ran to the next room and found Dylan, her roommate's boyfriend, unconscious on the floor. Samantha called 911 and a few seconds later Dylan's breathing stopped, leading to cardiac arrest. The 911 operator asked Samantha if she knew CPR. She did and quickly began performing CPR on Dylan's lifeless body.

"It was an automatic thing; I knew I had to do it (CPR). I didn't really think," remembers Samantha.

Samantha had learnt the lifesaving skill from her physical education teacher through the ACT High School CPR Program when she was in Grade 9 at East Elgin Secondary School in London, Ontario.

Dylan survived his cardiac arrest. "I really can't put it into words," Dylan says, as he talks about Samantha's actions that day. "She saved my life. If it wasn't for Samantha knowing CPR, I could have been dead."

Samantha urges everyone to learn CPR. "You hope you will never have to use it but if you do, you're going to be so happy that you know what to do. Things like this don't just happen to young people, but to older people as well," she says.

Call to action:

- Ask your teen if they learned CPR in school this year. If not, find out how you can bring the program to your school.

- Check ACT's list of schools to see if your school has a CPR program.

- Learn CPR!

To learn more visit and "like" us on Facebook.


The ACT Foundation is a national charitable organization dedicated to establishing CPR as a mandatory program in every Canadian high school. ACT's health partners who are committed to bringing the program to all high schools across Canada include AstraZeneca Canada, Bristol-Myers Squibb Canada, Pfizer Canada and sanofi-aventis. The Foundation has already established the CPR program in more than 1,500 high schools and more than 1.8 million youth across Canada have been trained to date.

To view the photo associated with this press release, please visit the following link:

To view the video associated with this press release, please visit the following link: