Bystander CPR : why all the fuss?

Abstract

In Europe, approximately one person suffers a cardiac arrest every 45 seconds, totalling 2-3,000 per day and 350,000 per annum. Indeed, sudden cardiac arrest without resuscitation is the third most common cause of death in industrialised nations. In the majority of cases, cardiac arrest is fatal and <10% of victims of ‘out-of-hospital’ arrest survive to discharge from hospital. Furthermore, given that irreversible brain damage secondary to the cessation of cerebral blood flow is established within just 3-4 minutes, survival is often associated with significant neurological disability and an inferior quality of life compared with their pre-arrest state. Cardiopulmonary resuscitation (CPR) associated with defibrillation, if delivered effectively and promptly within 1-2 minutes of cardiac arrest, may improve the chances of survival 3-4 fold or, rather more optimistically, to around 60%. However, the ‘time to intervention’ is paramount and survival decreases by 10% for every minute delay in the initiation of CPR. Conversely, studies from Denmark, amongst others, have shown that prompt initiation of effective bystander CPR will more than triple survival and save 200,000 victims in Europe and the US and, if extrapolated worldwide, save more than 300,000 lives per annum.