Better Health For All

Community cardiopulmonary resuscitation (CPR) teaches people living in the local community the basic skills of delivering chest compressions and artificial breaths until lifesaving defibrillation can take place for people that have suffered a cardiac arrest (their heart has stopped beating). Many causes of cardiac arrest are reversible with the right treatment, but without CPR and early defibrillation people do not survive long enough to receive these treatments. On average only 10% of people who suffer a cardiac arrest outside a hospital setting will survive. This figure more than doubles when the victim receives community CPR(1).

History of CPR

We haven’t always had this valuable skill at our disposal. People have been trying to resuscitate victims of cardiac arrest since the 1500s, with varying levels of success. By the 1800s the accepted method of treating cardiac arrest became surgically opening the chest and massaging the heart by hand(2). The first publicised mention of CPR as we know it today appeared in Journal of American Medical Association in 1961, entitled ‘Closed Chest Cardiac Massage’. The revolutionary new technique was an alternative to the currently accepted technique of open heart massage(3).

Community CPR in the East Riding of Yorkshire

The East Riding of Yorkshire is a predominantly rural locality. Precious minutes can be lost before victims of cardiac arrest receive CPR, making community CPR even more important. The local council is offering free 1 hour drop-in sessions on CPR and defibrillation to their employees and the public, giving people the opportunity to feel more confident about what to do if someone close to them suffers a cardiac arrest be it family, a friend or someone on the street. The events are advertised using the council intranet and Facebook page and have been received very well. 100% of the feedback collected has been positive and all attendees reported improved confidence performing CPR and using a defibrillator. The council also took part in the British Heart Foundation’s ‘Restart a Heart’ day, raising awareness and training around 50 employees in CPR. There is a common misconception that you have to have a qualification to perform CPR on somebody. The truth is that is you have the knowledge, you can use it to try and save someone’s life.

Automated external defibrillators (AEDs) talk you through how to deliver an electric current to restore a person’s own heartbeat. There are over 100 publicly available AEDs in the East Riding of Yorkshire and Hull, a number the council and partners have worked hard to increase(4). When you call 999 the operator will direct you to the nearest AED if needed, and give you the code to open the safety box. AEDs are much less useful when CPR does not take place – something the council has recognised in its efforts.

The Yorkshire Ambulance Service are also working to address this issue with a successful community responder scheme. Community responders are normal people who are trained to provide initial lifesaving treatment and help to bridge the gap until paramedics arrive.

Community responders carry portable AEDs and are often able to reach the people who need them much faster.

Does it work?

The resus council recognises a Chain of Survival for Cardiac Arrest, which includes: early recognition of cardiac arrest and calling for help, early CPR to buy time and early defibrillation to restart the heart. When each link in this chain is strong, chances of survival can rise to over 50%(5), but if one part of the chain is delayed this percentage drops dramatically.

FAQs

‘Is it difficult to do?’

Research has shown that life-saving skills such as CPR can be taught successfully to children as young as 10 years old, whereas younger children aged 4 and above have been shown to be capable of calling for help and operating an AED correctly(1). In fact the Department of Education has plans to add CPR and first aid to the curriculum by 2020(6).

‘What if I hurt them, can I get sued?’

When a person has a cardiac arrest they are effectively dead. You cannot make the situation worse, but you may save their life. Sometimes you can crack a rib when giving CPR, but broken bones will heal and are a small price to pay for your life. No one in the UK has ever had legal action brought against them for trying to help someone by giving them CPR(5).

‘How can I get involved?’

The worldwide annual Restart a Heart Day courtesy of the British Heart Foundation takes place on the 16th of October. Why not raise awareness and join the millions of people all over the world learning CPR to keep each other safe. You can also look out for local BHF Heartstart schemes which run free 2 hour courses across the country. The easiest way to learn about CPR is via the British Heart Foundation website where you can browse their free information and videos.

References

1. Plant. N, Taylor. K. (2013). How best to teach CPR to schoolchildren: A systematic review. Resuscitation. 84, 415-421
2. CPR & First Aid Emergency Cardiovascular Care . (2019). History of CPR. Available: https://cpr.heart.org/AHAECC/CPRAndECC/AboutCPRFirstAid/HistoryofCPR/UCM_475751_History-of-CPR.jsp#10. Last accessed 25/4/19.
3. CLOSED CHEST CARDIAC MASSAGE-P. Safar. Anesth. Analg. -Vol. 40:609 (Nov.-Dec.) 1961.
4. OpenStreetMap. (2010-2019). Defibrillators in HU postcode area.Available: https://osm.mathmos.net/defib/progress/HU/#11/53.7516/-0.5493. Last accessed 9/7/1
5. Resuscitation Council (UK). (2019). Frequently asked questions: CPR.Available: https://www.resus.org.uk/faqs/faqs-cpr/. Last accessed 10/5/19.
6. Resuscitation Council (UK). (2019). CPR Education Campaign: CPR to be added to the school curriculum. Available: https://www.resus.org.uk/campaigns/cpr-education-campaign/. Last accessed 9/7/19.

Written by Isabella Price, FY2 Doctor in Public Health, East Riding of Yorkshire Council