A cardiac arrest is an electrical problem.
It occurs when the hearts’ electrical system malfunctions so that the heart muscle quivers or fibrillates rather than pumping blood. With its pumping action disrupted, the heart cannot pump blood and oxygen to the brain, lungs and other organs. As soon as this event occurs, a person loses consciousness, collapses and stops breathing. The person is considered clinically dead and the critical actions that are required to attempt to save a life include:
CALL – Call 000 for an Ambulance
PUSH – Commence Cardiopulmonary Resuscitation (CPR) immediately
SHOCK – Use an Automated External Defibrillator (AED) if one is available
A person can go into cardiac arrest without any warning or notable symptoms. Signs of a cardiac arrest include:
- Sudden collapse
- Loss of consciousness
- Non or irregular breathing
- No pulse
- No sign of life
A heart attack is a plumbing or circulation problem.
It occurs when blood flow to the heart is blocked. If the blocked area is not repaired & reopened quickly, that part of the heart begins to die. The longer a person goes without treatment, the greater the damage.
The person will be conscious and breathing but will be unwell. Urgent medical treatment is required, and you MUST call 000!
A severe heart attack, where there is a significant blockage in the heart, can lead to a person going into cardiac arrest.
Common signs of a heart attack include:
- Neck, jaw, arm and/or chest pain or tightness (but not always)
- Shortness of breath
- Dizziness or lightheaded
Symptoms will vary from person to person and can be different between males and females.
The Chain of Survival is recognised Internationally as a set of actions that are required to increase a person’s chance of surviving a cardiac arrest. If the links in the chain align and are done quickly, the person’s chance of survival can increase from less than 9% to more than 60%.
The first 4 links in the chain of survival rely on the community and bystanders to:
1. Recognise a cardiac arrest
2. Call Triple 000 (Ambulance).
3. Commence CPR and
4. Use a defibrillator (AED – if available).
Further support is then provided by the Ambulance Service in your state and advanced care in Hospital.
DRSABCD is taught in basic first aid in Australia and are steps that should be followed in every first aid emergency:
D – Danger?
R – Responsive?
S – Send for Help
A – Open Airway
B – Normal Breathing?
C – Start CPR
D – Attach Defibrillator (AED)
DRSABCD is also how to diagnose a person who is in cardiac arrest. If a person is unconscious and not breathing normally, you need to commence CPR and use a defibrillator (AED), if one is available.
Early and effective CPR is vital in a person’s ability to survive a cardiac arrest! It assists with both the flow of oxygen to vital organs and buys valuable time before the Ambulance arrives.
CPR is considered more important in comparison to the defibrillator (AED).
Effective CPR is defined as:
- 30 compressions : 2 Rescue Breaths OR Hands Only CPR
- Compressions 1/3 depth of the chest
- 100-120 compressions per minute
- CPR is physically tiring – rotate person doing CPR every 2 minutes
The above CPR rates are recommended for babies, children and adults.
A defibrillator (Automated External Defibrillator or AED) is a piece of equipment that, in cardiac arrest events, is attached to the person’s chest and its technology analyses the heart to determine if a shock is required to attempt to restart it.
The machine looks to see if the person is in a “shockable rhythm” (primarily VF or ventricular fibrillation). The shock will momentarily stop the heart function in the hope it will kick back into a normal rhythm. When the heart has been restarted, the person will commence breathing on their own.
If a person is not in a “shockable rhythm”, the machine will not provide a shock. The machine cannot be misused.
The defibrillator provides voice instructions on how to operate it and includes additional support for the rescuer including metronome to keep CPR rate, timer for 2 minute cycles of CPR and CPR feedback (select models).
The defibrillator has a rescue kit with items that are required to use the machine. These include a razor (to minimise chest hair on males), gloves, face mask for CPR rescue breaths and scissors (to cut clothing).
The defibrillator is to be used in conjunction with CPR and DOES NOT replace a person doing CPR.
There are many reasons why a person will experience a cardiac arrest. It can happen to individuals of all ages, with or without any warning signs or symptoms. Below we have listed some of the health issues that could cause a cardiac arrest:
Severe Heart Attack
Genetic Heart Conditions (family history)
Electrical Issues of the Heart
Good Samaritan laws exist in every state of Australia and covers individuals for responding to medical emergencies within the basic life support framework.
A Good Samaritan under the Act is described as “a person who, in good faith and without expectation of payment or reward, comes to the assistance of a person who is apparently injured or at risk of being injured”.
Protection from personal liability will not apply if the:
- Good Samaritan’s intentional or negligent act or omission caused the injury
- Good Samaritan was under the influence of alcohol or drugs
- Good Samaritan failed to exercise reasonable care and skill
- Good Samaritan did the act or omission while impersonating a health care or emergency services worker or a Police Officer.
Calling an ambulance in a medical emergency can be stressful but it is important to try and remain as calm as possible.
When you call Triple Zero (000) you will be asked a series of questions by the Ambulance call taker:
- Your name
- The address, including nearest cross street
- The nature of the emergency.
As soon as you give your address, an ambulance is being allocated.
In cardiac arrests, the 000 call taker will stay on the line with you and provide you guidance with determining what to do and support for how to do CPR and how to use a defibrillator, if one is available.
Unfortunately the sternum and some ribs can fracture as a result of doing CPR – but that’s okay.
CPR works by keeping oxygenated blood flowing around the body in order to keep vital organs alive – the most important one is the brain.
Good CPR is 100 – 120 compressions per minute to a depth 1/3 of the person’s chest.
It is common for the sternum and ribs to break during CPR. This can be an unpleasant experience for the rescuer; however it is important to continue to deliver high quality compressions to the best of your ability.
If you do hear or feel bones break, reassess and ensure your hand placement is correct in the middle of the chest at the lower half of the sternum. Also reassess your depth of compressions.
Ribs can be treated and heal after the event. Remember cardiac arrest is not survivable without CPR.