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CPR Helps Quality of Life, Too

Study on bystander assistance refutes notion that patient ends up a wreck

MONDAY, Oct. 6, 2003 (HealthDayNews) -- People whose lives are saved because they get immediate cardiopulmonary resuscitation (CPR) from a trained bystander when their hearts stop beating can and do come back to full, healthy lives, a Canadian study shows.

The study was done to disprove a common belief that while CPR given by a volunteer can keep people alive, the survivors become severely disabled medical wrecks, says Dr. Ian Stiell, chairman of emergency medicine research at the Ottawa Health Research Institute and lead author of a report in the Oct. 7 issue of Circulation.

A detailed quality-of-life analysis was conducted on 268 people who survived cardiac arrest because they got bystander help. The researchers measured vision, hearing, mental ability, speech and other characteristics, finding an average score of 0.80 on a 0-to-1 scale, barely below the 0.83 score for the general population, the report says.

"The perception is that trying to save people by bystander CPR is futile," Stiell says. "That is not at all true, according to what we found."

The sad part of the study is that so few people are trained to give immediate CPR for cardiac arrest, which usually is caused by a temporary disorder of the heart's electrical signaling system, Stiell says.

In the Canadian study, only 14.3 percent of the more than 8,000 persons who experienced cardiac arrest had CPR administered by bystanders who had training in the technique.

"We think that bystander CPR is being sadly overlooked," Stiell says. "This number has not changed in the 10 years we have studied cardiac arrest in Ontario."

An estimated 250,000 people suffer cardiac arrest in public places each year in the United States, and only about 5 percent of them live long enough to get to the hospital, mostly because the emergency measures that can save their lives are not done in the brief window of time that makes the difference between life and death.

CPR, a coordinated effort of breathing into the patient's mouth and compressing the chest to keep the heart going, is an essential element of the lifesaving program. CPR is done to keep someone alive until defibrillation, an electric shock that restores heart rhythm, can be performed.

The new study "adds to a growing body of scientific information about the importance of immediate CPR in improving survival and quality of life," says Mary Fran Hazinski, a nurse in clinical care at Vanderbilt University Children's Hospital who acts as a senior science editor, reviewing reports for the American Heart Association.

"In all of these studies, a large contributor to survival was immediate CPR," she says. "In this new study, they were able to look at the effect of CPR alone, and they came to a pretty conclusive conclusion."

"Immediate" is the key word, Hazinski and Stiell say.

"The key is having someone there to do CPR right away, rather than waiting for a professional such as a fireman," Stiell says. "Often, you don't have time to wait for the fire department to show up. It's too late by then."

For example, in Las Vegas casinos that have an organized CPR effort, 74 percent of cardiac arrest patients survived to be discharged from the hospital when emergency care began within three minutes. A two-minute delay in beginning care reduced the survival rate to 49 percent.

At Chicago's O'Hare and Midway Airports, which also have organized programs, one report found that 14 of 18 people who experienced cardiac arrest survived when emergency care began within three minutes, Hazinski says.

The American Heart Association has a continuing effort to get ordinary people to learn CPR, she says, something that can be done in a two- to four-hour training session. Anyone interested in CPR training can get information from the local branch of the heart association, Hazinski says.

More information

The basics about CPR can be found at the American Heart Association or Amherst College.

SOURCES: Ian Stiell, M.D.; chairman, emergency medicine, Ottawa Health Research Institute, Canada; Mary Fran Hazinski, R.N., clinical care nurse, Vanderbilt University Children's Hospital, Nashville, Tenn.; Oct. 7, 2003, Circulation
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