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Sunday, May 27, 2012

We're not paying attention to the data, folks.

Fact: two thirds of all cardiac arrests in the U.S.A. occur in the home. (First five years of CARES data)

Fact: average survival rate in the U.S.A. is 7+% ("survival" is defined as getting discharged from the hospital with CPC=1 or 2. A score of "1" means no neurological damage; "2" means some damage, but still able to perform the activities of daily living without assistance.)

Fact: any bystander involvement can raise the survival percentage into the low-to-mid-twenties. (recent 29,000+ cohort Danish study.)

Fact: the Phoenix Airport CPC=1 or 2 survival rate for witnessed cardiac arrests has averaged 75% for ten years.

When you see an out-of-hospital sudden cardiac arrest - and there's a fourteen percent chance that you will at least once in your lifetime - there is a greater than 85% chance that the victim will be a family member, a friend, or an associate. That means that we each have a greater than ten percent chance of seeing a family member, friend, or associate die - at least once in our lifetime.

When that happens, you will call 911 and unlock the front door, if you are at home. If this is all you do, the ambulance will usually arrive in 8-12 minutes (that's probably 10-14 minutes after the victim arrested, because of the time it takes to figure out what's going on, the time it takes to call 911, and the time it takes for 911 to figure out which ambulance is to respond, and for that ambulance to get rolling.) If this is the scenario that unfolds, the victim will have about a 7% chance of getting out of the hospital with at least major brain functions intact. (If the arrest happened at home, the odds drop to 4% if witnessed or 2% if either not witnessed or not recognized as being a cardiac arrest by those present.)

Thus, the first major battle to win is that of making your home more like the Phoenix Airport. I'm not talking about putting runway lights on the sidewalk and driveway. What I'm talking about is:

  1. Get trained in Bystander CPR so that you will be able to recognize a cardiac arrest when you witness one and will be able to react appropriately.
  2. Get a personal AED. Keep it in a place where you can get to it quickly - for example, while you're hurrying to unlock the front door while you are calling 911 on your portable or cell phone. If you have a personal AED, you will be able to use it before the ambulance even starts rolling, and using the AED within a minute or two or three of the arrest carries a far, far higher probability of a good outcome. The best the ambulance is going to be able to do is 10-14 minutes.
  3. Practice what you are going to do, and keep your training current.
If you cannot find a CPR class, go to, click on the "For Past Trainees" link in the left-hand column, and download the class video.