Nearly one third of patients who receive effective CPR (cardiopulmonary resuscitation) ends up with a broken rib. The idea of breaking a rib can make people hesitant to learn CPR. And the thought of mouth-to-mouth makes reasonable people nervous about possible infection. The good news is you don’t have to perform mouth-to-mouth anymore. And you can’t make someone whose heart has stopped worse by performing CPR. That’s about as bad as it gets.

As an example, if my heart stops beating, I will not ask to see the certification card in your wallet before you start chest compressions. I’ve got a husband, kids and big plans. Please don’t worry that you are doing it wrong, just do it!

We’ll get to just how easy it is in a moment.

Out of Hospital Sudden Cardiac Arrest

Sudden cardiac arrest means the heart stops beating…it is no longer pumping blood. This is different from a heart attack, though a severe heart attack can lead to sudden cardiac arrest. Arrhythmias, valve abnormalities, drug use, and other health issues can also cause it.

According to the Sudden Cardiac Arrest Foundation(SCAF), 326,000 people in the U.S. experience out-of-hospital sudden cardiac arrest each year. Only one in ten survives. Delay in receiving CPR or defibrillation contributes to the low survival rate. To put that in perspective, SCAF explains that out of hospital sudden cardiac arrest is responsible for the deaths of as many people as “Alzheimers disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined. “

The Lifesaving Alphabet: CPR and AED

CPR is the acronym for cardio-pulmonary resuscitation. The American Heart Association promotes Hands-Only™ CPR that simply involves compressing the victim’s chest at the rate of 100 beats per minute. That’s about the tempo of the Bee Gees’ catchy 70’s disco tune, Stayin’ Alive.

Chest compressions pump the heart that is unable to pump itself. Previous CPR procedures included mouth-to-mouth breathing, but research now shows that enough oxygen remains in the blood without it.  Chest compressions are the key to getting that residual oxygen delivered to the brain. In fact, a break in chest compressions to perform mouth-to-mouth allows the blood pressure to drop too low. This can prevent adequate oxygen delivery to brain tissue. 

The second intervention that can be life saving for an individual whose heart has stopped is automatic external defibrillation, or AED.  The heart’s pump works because of an electrical circuit that causes the heart muscle to contract regularly. In sudden cardiac arrest, the electrical pathways are disrupted, often causing a situation known as ventricular fibrillation. The use of AED can shock the heart back into a coordinated rhythm. 

AED devices are now widely available in public places such as airplanes and shopping malls. In addition, they are easy to use for most any bystander. The devices detect heart rhythms and will only deliver a shock when appropriate.

Benefits of Bystander Intervention

In recent years, North Carolina implemented an initiative to increase CPR and AED by first responders and bystanders while waiting for EMS arrival. A significant improvement in outcomes for individuals with out-of-hospital sudden cardiac arrest resulted.

This study of 4,961 patients ran from 2010 to 2013 and was recently published in the Journal of the American Medical Association. The results showed that patients who had to wait for EMS to arrive and initiate CPR and AED only survived 15.2 percent of the time. However, patients who received CPR and AED from bystanders enjoyed a 33.6 percent survival rate and better neurological outcomes.

It is clear that the delay in waiting for EMS to arrive to initiate treatment has a significant impact on survival.

How You Can Help

If a teen or adult experiences sudden cardiac arrest (their heart isn’t beating) call 911 and start chest compressions. By definition the individual is already dead, so chest compressions can only help them. The 911 operators will talk you through it. The American Heart Association recommends this even if you are not certified in CPR.

However, those trained in CPR tend to give more effective CPR, so it’s still a good idea to go ahead and take a class. You will be more confident should such an emergency arise. You can find classes through the American Red Cross, the American Heart Association, and many other organizations. In addition, the approach for children is different and should be learned in a class to be most effective.

Finally, if you are certified in CPR, download PulsePoint to your phone to receive alerts to emergencies nearby. If your travel time to the emergency is shorter than that of EMS, you might be the difference between life and death for someone.

They probably won’t mind a broken rib.