Damar Hamlin, cardiac arrest and what it takes to boost the odds of survival : NPR

Players look on Monday as Damar Hamlin of the Buffalo Bills is treated by paramedics at Paycor Stadium in Cincinnati, Ohio.

Image of Kirk Irwin/Getty

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Image of Kirk Irwin/Getty

Players look on Monday as Damar Hamlin of the Buffalo Bills is treated by paramedics at Paycor Stadium in Cincinnati, Ohio.

Image of Kirk Irwin/Getty

Moments after he went into cardiac arrest at the scene on Monday, Damar Hamlin, who was safe for the Buffalo Bills, was given CPR and paramedics were called in to restart his heart. . That quick response is said to have greatly improved his chances of survival and recovery.

University of Cincinnati Medical Center, where Hamlin has been listed in critical condition, report Fifth, a “significant improvement” in his condition.

UCMC’s Dr Timothy Pritts said: “As of this morning, he began to wake up and it appears that his condition and neurological function are intact. “This marks a really good turning point in his ongoing care.”

For more than 350,000 Americans Every year people experience cardiac arrest outside of the hospital, the prognosis is not always optimistic. Most studies suggest that no more than 10% of these patients survive until discharge.

That may seem grim, but medical experts say the statistics mask individual outcomes much better for patients who receive prompt and appropriate care before they reach the hospital.

For many, trained bystanders are the key to survival

Jeff Feig, 56, a private investor, was relaxing at a summer community in 2016 in Westchester, NY, when suddenly he found himself out of breath.

“It was like a switch. I felt terribly sick. I remember thinking, I have to sit down,” he said.

Feig only learned the rest of the story from bystanders, some of whom were quick to intervene and are credited with helping to save his life. “My heart stopped. My eyes widened. I foamed at the mouth,” he said.

Feig’s out-of-hospital cardiac arrest, also known as OHCA, occurred under circumstances that certainly increased his chances of survival. Just a week earlier, the bystanders who had helped him had received CPR training and instruction in the use of the community’s automated external defibrillator, or AED, a device that allows those with minimal training to deliver a potentially life-saving shock to a person in cardiac arrest. Many AEDs are now programmed with verbal commands to speak to the user during the process.

One survey 2018 of the Cleveland Clinic found that more than half of Americans (54%) report that they know how to perform CPR, but only about 11% know the correct pace to perform chest compressions (100 to 12 beats per minute). ). Recently survey published in Journal of the American Heart Association found that only 18% of people were updated on their CPR training.

In the so-called “life chain,” rapid recognition of sudden heart failure, early CPR and early defibrillation, said Dr. Myron Weisfeldt, professor of medicine at Johns Hopkins University. key.

Most out-of-hospital cardiac arrests occur at home

About 70% of out-of-hospital cardiac arrests (OHCA) occur at home, another 18.8% in public facilities and 11.2% in nursing homes, the World Health Organization reports. . American Heart Association. In many cases, family, friends and bystanders don’t know how to respond, says Weisfeldt, who has written or co-authored several articles on OHCA.

That uncertainty wastes precious time and quickly reduces survival rates, he said.

The data shows that for every minute that defibrillation is delayed, the chance of survival decreases by 10%, according to Weisfeldt.

With OHCA’s CPR and in-field defibrillation, however, the odds of making it go up dramatically, he said.

CPR is considered an “effective bridge” to defibrillation, according to Weisfeldt. “Fast defibrillation is really important for survival and survival with good brain function,” he said.

AEDs have become common in many high-traffic buildings and in nursing homes, and different state laws require their placement in schools, health and fitness centers, public golf courses, and gambling establishments.

In the home, such devices are rare, said Dr. Douglas Kupas, EMS physician and medical director of the National Association of Emergency Medical Technicians.

And even in public places, the AED’s location may not be obvious. In those cases, it is important for a person to start chest compressions immediately. If there are other people, he said, they should be AED seekers.

“That makes a lot more sense than … the only person who knows CPR running around the building,” said Kupas, who is also the resuscitation program director for Geisinger Health Systems in central Pennsylvania. to try to find the AED”.

Being healthy increases the odds

Dr. Stephen Anderson, an emergency physician who recently retired after 35 years of practice in Seattle, said being healthy “dramatically increases” your chances of surviving OHCA.

To illustrate how a quick response can make a big difference for patients like this, Anderson points to the example of a casino just eight miles from where he works.

“If you fall to the ground in a casino, they respond immediately” with CPR and defibrillation from the AED, says Anderson.

“I’ve taken care of countless people… people who had a cardiac arrest at the casino and come [into the hospital] talk and stay awake,” he said.

What can you do?

Doctors say that if more people were trained in CPR, including the use of AEDs, more lives could be saved. Keeping that training up to date is also important.

“Any form of skill reinforcement is very, very helpful,” says Kupas. “But I think we have to get rid of the idea that you have to be fully trained, you have to be certified, you have to have an unexpired card, otherwise you’re not going to be good at this.”

“If you take [CPR training] 20 years ago, you probably still knew a little better how to do compression than someone who had never done it,” he says.

“The bottom line is pushing hard and accelerating,” agrees Anderson, who says the recommended rhythm for chest compressions is to the beat of the 1970s Bee Gees hit.Still alive.”

But even people with no training can perform CPR, Kupas said.

“We’re seeing more and more of these out-of-the-box CPR being performed [after] training directly by the dispatcher,” he said.

“They’re just reading from a script — ‘put your hand right in the middle of your chest midway through that nipple line, press down and press up, then they start counting for them,'” he says.


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