Sudden cardiac arrest occurs when the heart suddenly, and without warning, stops beating. This event causes hundreds of thousands of deaths in the U.S. every year. Without immediate help, people who have sudden cardiac arrest can die within minutes. According to Clifton W. Callaway, MD, PhD, professor of emergency medicine at the University of Pittsburgh, it affects one person a day in Pittsburgh on average.
Cardiopulmonary resuscitation (CPR) is the first step in saving the life of someone who has sudden cardiac arrest. From 2000-2005, people in Pittsburgh were taught to give 15 chest compressions and two breaths (15:2). But Dr. Callaway’s research, and that of others, found that every time chest compressions are stopped to give breaths, the blood pressure created by the compressions drops off. Dr. Callaway and his group began preliminary testing and started training local first responders to do 30 compressions and two breaths (30:2). Researchers tracked patient outcomes before and after this change and found that they were more successful at getting pulses back by doing 30:2. Dr. Callaway and his group weren’t the only ones doing research on this, but they had helped Pittsburgh first responders switch to 30:2 well before the CPR guidelines were changed. Now, 30:2 is part of the international CPR guidelines.
One of the questions researchers are studying now is, if 30:2 is better than 15:2, would it be even better not to pause chest compressions at all and just blow some oxygen into the patient every 10 seconds or so? In Pittsburgh, first responders are now being trained to do either 30:2 (pausing to give two breaths) or continuous chest compressions while blowing oxygen. Some ambulances are doing one and some are doing the other. Dr. Callaway and his group are tracking all the outcomes in the region to answer that question.
Because patients can’t give consent to participate in research if they are having an emergency, resuscitation researchers like Dr. Callaway have to follow particular rules. Regulations allow for exceptions from informed consent for research in emergency situations. Researchers are permitted to try things if the study meets certain guidelines set by the Food and Drug Administration, the national Office for Human Research Protections and local institutional review boards. Anyone looking for information about studies going on in the region can go to http://acutecareresearch.org/ or call 412-647-3078.
It’s also important to remember that this is emergency research. It’s taking place in a life-threatening situation. Researchers aren’t studying procedures to see if they would be cheaper or easier. They are only doing things that have a real chance of helping someone stay alive.
According to Dr. Callaway, the best way of preparing for a sudden cardiac event is to learn CPR. People don’t have to go to a class or get certified. They can learn the basics online, at a public event or even from a health care provider. Don’t be afraid to help someone. Know how to activate the emergency system, which begins by calling 911. It’s what stands between you and a bad outcome some rough day.