Evidence That Bystander Intervention Actually Saves Lives

Stepping in if you see someone experiencing cardiac arrest actually pays off, studies show. (Photo: Leon Brocard/Flickr)

More people are intervening when they see someone experiencing cardiac arrest — and that is associated with improved survival rates, according to recent research.

Two studies published in the Journal of the American Medical Association show that increased bystander intervention (with chest compressions or use of a defibrillator) is associated with improved survival rates and neurological outcomes for those who experience out-of-hospital cardiac arrest.

Out-of-hospital cardiac arrest accounts for approximately 200,000 deaths per year in the United States.

Cardiac arrest is not the same as a heart attack. “A heart attack is a sudden total blockage in one of the main arteries to the heart” — similar to a “plumbing problem, Joshua M. Cooper, MD, a professor of medicine and the director of the cardiac electrophysiology program at the Temple University School of Medicine, who was not involved in the new studies, tells Yahoo Health. “This complete blockage is almost always the result of a blood clot that suddenly formed inside the artery right next to a cholesterol build-up that had silently been there for years.”

A heart attack usually has symptoms including chest pain or pressure, nausea, sweating, and shortness of breath, he explains. “Typically, a heart attack does not cause the person to lose consciousness or collapse.”

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In contrast, a cardiac arrest is a heart rhythm problem, or an “electrical” problem. “It is usually due to the bottom pumping chambers suddenly going into an extremely fast electrical rhythm, kind of like a heart seizure,” he says. “When the heart suddenly accelerates out of control, it cannot properly pump blood to the brain and the rest of the body, so the blood pressure falls to zero and the person quickly loses consciousness and collapses to the ground.”

The first study, conducted by researchers in Japan, included 167,912 bystander-witnessed, out-of-hospital cardiac arrest incidents that occurred between January 2005 and December 2012 in Japan. Researchers found a correlation between an increase in bystander intervention and the neurologically intact survival of the cardiac arrest patients.

The second study, conducted by researchers at the Duke University School of Medicine, examined the outcomes and changes in bystander and first-responder resuscitation efforts for cardiac arrest patients following statewide initiatives to improve these efforts in North Carolina. The initiatives included training members of the general population and first-responders both in CPR and in the use of automated external defibrillators (AEDs).

Researchers found an association between bystander intervention after the statewide initiatives, as well as an increase in cardiac arrest patient survival.

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In incidents of cardiac arrest, “if this electrical storm stops on its own, the person can wake back up on their own,” Cooper says. “But if the extremely rapid electrical rhythm continues, that person will remain unconscious until they are rescued by other people who are able to restore blood flow to the brain and body within a few minutes.”

The treatment for a cardiac arrest is an electric shock from an external defibrillator, which essentially can “re-set” the heart back to its normal rhythm. If this shock can’t be immediately delivered, then chest compressions need to be used in the meantime to force blood to circulate from the heart around the body. “Brain damage can occur after only a few minutes without blood flow to the head, but if a rescue shock is delivered quickly, the person have a full recovery without any long-term consequences,” Cooper explains.

“The most important thing for a bystander to know is that if they witness someone suddenly collapse to the ground, there are only a few minutes available to save that person’s life,” adds Cooper. “Ideally, at least two people should participate in the rescue effort — one to start CPR … and one to call 911 and/or run to get the nearest automatic external defibrillator.”

Cooper explains that a person with no medical training can be taught how to administer CPR and how to use an AED in under 30 minutes time. And simply performing chest compressions — even without the mouth-to-mouth element in CPR —can be very effective to improve survival after a cardiac arrest.

To administer hands-only CPR, the American Heart Association advises bystanders to press hard and fast in the center of the chest to the beat of the song “Stayin’ Alive.”

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