Sudden Cardiac Arrest (SCA) claims the life of about 295,000 people every year (American Heart Association, 2012). SCA is a leading cause of death among adults over 40 and it can also affect the under 40 population. More people die each year from SCA than from colorectal cancer, breast cancer, prostate cancer, auto accidents, AIDS, firearms and house fires combined (Sudden Cardiac Arrest Foundation). Early cardiopulmonary resuscitation (CPR) can effectively treat individuals suffering SCA. By using an automated external defibrillator (AED) prior to medical personnel arriving survival rates can further increase. (American Heart Association, 2012).

An AED is a light weight portable device that analyzes and checks for an electrical disturbance. When appropriate an AED shocks the heart back into a functional rhythm. AEDs are geared for use by non-medical persons. AEDs talk the rescuer through the process of placing the pads of the device on the patient, analyzing the electrical activity and direct the rescuer to push the shock button, if indicated. The shock defibrillates the victim's heart back into a normal heartbeat. AEDs are found throughout our community at gyms, schools, malls, airports, office complexes and many other public places. AEDs continue to be a safe and effective method for increasing the survival rate of victims of SCA.

Early CPR and rapid defibrillation (using an AED) combined with early advanced emergency care can produce high survival rates for victims of witnessed cardiac arrest. Advanced care in the form of the local Emergency Medical Services is initiated by calling 9-1-1. The paramedics bring the advanced treatment to the patient's side; essentially bringing the Emergency Department to you. In some cities with public access defibrillation or "community AED programs," when bystanders provide immediate CPR and defibrillation within 3 to 5 minutes of a witnessed cardiac arrest, the reported survival rates are as high as 48 to 74 percent in these settings. (American Heart Association, 2012)

Causes of SCA include a variety of electrical conduction abnormalities in the heart. SCA is not the same as a heart attack, but a heart attack can lead to SCA. A heart attack is caused by a blockage in one of the blood vessels in the heart. Many, but not all victims of SCA have had some type of heart disease, such as congestive heart failure and/or a prior heart attack. SCA occurs when the electrical problem causes failure of the heart to pump effectively or not pump at all. The most common electrical problem or arrhythmia in cardiac arrest is ventricular fibrillation. Immediate treatment increases the chance of survival. This immediate treatment includes early CPR and early defibrillation. Without the early intervention SCA will lead to death (Sudden Cardiac Arrest Foundation).

Presentation of SCA

• Sudden collapse
• Loss of consciousness
• Loss of pulse
• Stoppage of breathing

Presentation of a heart attack

• Pressure, squeezing or pain in the chest
• Pain spreading to the shoulders, neck or arms
• Symptoms with sweating, nausea or shortness of breath
• Unexplained anxiety, weakness or excessive tiredness

The Centers for Disease Control and Prevention (CDC) and the Department of Emergency Medicine at the Emory University School of Medicine established the Cardiac Arrest Registry to Enhance Survival (CARES) in 2004. The CARES Registry has over 30,000 victims of SCA in its registry from October 1, 2005 to December 31, 2010. The CARES Registry reports only a 9.6% survival rate. The highest out of hospital survival rates are seen in recreational/sport facilities, airports, physician offices, educational institutions and public buildings. The lowest survival rates are seen in nursing home/assisted living facilities, home/residence and residence/institutions. (Centers for Disease Control and Prevention, 2011) The American Heart Association (AHA) reports that 88% of the SCA that occur outside the hospital happen at home (Lifesaver Education, 2012). By initiating CPR, you can make the difference between life and death for someone suffering from SCA by acting quickly. With more people trained to act quickly the rate of survival would increase.

By recognizing the presentation of SCA and learning CPR you can help increase the survival rate of victims of SCA.

• The Chester County Hospital is currently offering an in-house CPR Hands-Only research program to family members of current patients in the hospital who are at risk for a heart attack. The CPR Hospital-Initiated Training Program (CHIP) takes less than 60 minutes to complete. The CPR Anytime program developed by the AHA. Interested parties could contact our Cardiovascular Nurse Navigator at 610.220.0432.
• Additional training including the complete basic life support course is available through Good Fellowship Training Institute 610.431.2303 or www.goodfellowship.com or through the American Heart Association www.heart.org.

After you receive CPR training you are ready to act fast to help a person who is experiencing SCA. When someone suddenly collapses you can jump into action:

• Call 9-1-1 or have someone else call 9-1-1. Be sure to communicate with a specific person. Otherwise bystanders in a crowd may hesitate and wait for someone else to help.
• Begin CPR, the chances for survival decrease 10% with each passing minute after collapse. You may be the victim's only hope for survival.
• If an automated external defibrillator (AED) is not immediately available send someone to retrieve it and bring it to you. As soon as possible, apply the AED electrode pads to the person's chest as shown on diagrams that accompany the AED. Follow the voice and visual prompts.

So, who is at risk? The following represents people who are at risk for SCA. (Heart Rhythm Society)

• People with a prior history of a heart attack (75% of individuals who die from SCA hadevidence of a previous heart attack)
• Family history of SCA, heart failure or heart attack
• Unknown case for abnormal heart rate
• Episodes of fainting for unknown reason
• Low ejection fraction

Remember saving victims from sudden death due to SCA depends on immediate bystander intervention. You can help prevent sudden death!

Victims of Sudden Cardiac Arrest come from all walks of life.

• Susan K, 39 years of age, was out jogging in preparation for a half marathon when she collapsed and is here today spreading her story. See her complete story>>
• Brian D, age 40, a member of the US Masters Swimmer group, during his regular morning swim suffered a sudden cardiac arrest and shares his experience>>.
• Susan, a 66 year-old school nurse, who follows a vegan diet and has normal lipid profile, did not feel right after being out for a movie that evening. She had developed shoulder pain, eventually chest pain. Her husband called 9-1-1. While on the phone, she suffered sudden cardiac arrest. View her story>>
• Evan, a fit healthy young man, 24 years of age, collapsed after making a basket on the court. CPR was started; the AED called for and 911 was called. He now shares his story.
• More survivor stories at Sudden Cardiac Arrest Foundation.

To see if you or a loved one is at risk of sudden cardiac arrest or heart disease follow the links below:

• Assess your risk of Sudden Cardiac Arrest
• Assess our risk factors for cardiovascular disease

It is up to you to take action:

• Learn CPR
• Commit to help
• Learn your risk factors

Bibliography

• American Heart Association. (2012, August 3). Sudden Cardiac Arrest - Advocacy. Retrieved Spetember 10, 2012, from American Heart Association: www.heart.org
• Centers for Disease Control and Prevention. (2011). Out-of-Hospital Cardiac Arrest Surveillance--Cardiac Arrest Registry to Enhance Survival (CARES). Atlanta: Centers for Disease Control and Prevention.
• Heart Rhythm Society. (n.d.). Understanding the Dangers of SCA. Retrieved September 10, 2012, from Heart Rhythm Society: http://www.hrsonline.org/News/SCA-awareness/sca_research.cfm
• Lifesaver Education. (2012, April 25). lifesavered.com. Retrieved September 18, 2012, from Lifesaver Education: http://www.lifesavered.com/blog/sudden-cardiac-arrest-information-and-statistics.aspx
• Sayre, M. R., Berg, R. A., Cave, D. M., Page, R. L., Potts, J., & White, R. D. (2008). Hands-Only (Compression-Only) Cardiopulmonary Resucitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest: A Science Advisory for the Public From the American Heart Association... Circulation , 2163-2166.
• Sudden Cardiac Arrest Foundation. (n.d.). Sudden Cardiac Arrest: A Health Care Crisis. Retrieved September 10, 2012 , from Sudden Cardiac Arrest Foundation: http://www.sca-aware.org/about-sca

Last Updated: 10/16/2012