2023 has been a flashpoint for sudden cardiac arrest awareness in this country with several high-profile incidents with professional athletes that engaged us in measuring our cardiac emergency preparedness and prompted dozens of new state and federal legislation to combat gaps in heart safety. Meanwhile this year, we’re shared dozens of stories of hometown youth out of the spotlight stricken by SCA, leaving their families and communities in a state of shock. And that’s just a fraction of the thousands of youth who suddenly collapse each year. The heightened exposure has left many parents wondering how to protect their kids’ hearts.
There are upwards of 350,000 out-of-hospital cardiac arrests each year in the U.S., including between 7,400 – 23,000 youth. According to Cardiac Arrest Registry for Enhanced Survival (CARES)1, survival rate to hospital discharge is just 9.3%. Survival has been under 10% for the past three decades. How is it we’re not improving these outcomes?
The answer lies in the fact that our communities are still unprepared to respond to a cardiac emergency, evidenced by the fact that just 40% of sudden cardiac arrest victims receive CPR from a bystander and only 11.3% received a shock from a publicly accessible AED. This is critically important when it’s understood an SCA victim needs immediate intervention in the first three to five minutes of collapse, and the median EMS response time is 7.8 minutes.
Even with this excellent EMS response, a cardiac arrest victim’s best chance of survival is when a bystander is ready to immediately CALL 911, deliver hands-only CPR (PUSH) and use the nearest automated external defibrillator (AED) (SHOCK) in the first minutes of collapse.
What’s worse, many studies show those outcomes are even lower for Black or Hispanic persons or for victims in a Black or Hispanic community. Compared to White children, CPR is 41% less likely for Blacks and 22% less likely among Hispanic children.
Communities that empower people to deliver hands-only CPR can triple a victim’s chance of survival and communities that make AEDs readily available can increase the survival rate up to 90% when the AED is used by a bystander in the first minutes of a victim’s collapse. The best way to affect these outcomes is with a cardiac emergency response plan. Studies show a written and well-practiced plan can increase overall survival rates to 50% or more.
October is Sudden Cardiac Arrest Awareness Month, which presents an opportunity to consider why it’s vitally important to be prepared to Call – Push – Shock in a cardiac emergency at home, in school, on the field and in the community.
While the general public is sometimes hesitant to use CPR and an AED, it is often misunderstood that a sudden cardiac arrest and a heart attack are not the same. While a heart attack victim is conscious and breathing, an SCA victim is not, although may make gasping sounds or shake as if having a seizure. Any effort made to keep their heart pumping until EMS arrives can only help, and 911 operators are ready to talk a bystander through this process. Good Samaritan laws protect bystanders who in good faith attempt to help an SCA victim. Federal law around this protection is also being improved to eliminate as many obstacles as possible. While it’s not necessary to be certified to help an SCA victim, having hands-on experience gives bystanders confidence to take quick action. There are many organized programs, but a t-shirt, towel and roll of toilet paper can also provide a helpful simulation.
We can also be more vigilant before sudden cardiac arrest strikes by recognizing warning signs and family heart history that put people at risk. Updated American Academy of Pediatrics (AAP) Bright Futures guidelines for preventative care call for regular heart screening of all youth and parents should be prepared to engage their pediatrician in annual cardiac risk assessment. However, the protocol falls short of comprehensive screening as it does not include preventative diagnostic testing, such as an electrocardiogram (ECG) or echocardiogram, instead only favoring follow-up for youth who report warning signs or family history. AAP statements recognize that warning signs are often missed by youth, parents and practitioners alike, so the protocol leaves a critical gap in heart care. What’s more, studies continually show an ECG is significantly more effective in identifying youth at risk than a typical physical and history alone. In addition to the fact that on average 1 in 3003 youth has a heart abnormality that puts them at risk for SCA, many parents are left wondering why we don’t have a better standard of care for our children.
Parent Heart Watch has a wide range of resources to educate and empower parents, coaches, and educators. This October we urge you to learn how you can protect hearts in your home and community.
- Take the Prevention Promise
- Understand and remember Call Push Shock
- Share the knowledge with others
1 The Cardiac Arrest Registry to Enhance Survival (CARES) has become a reliable national registry chronicling the incidence of sudden cardiac arrest and survival statistics. CARES data collection comes from 30 state-based registries and 50 community sites in 16 additional states representing 175 million people or 53% of the US population.
3 Averaged from Fuller, 1997; Corrado, 2006; AHA 2007; Wilson, 2008; Bessem, 2009; Baggish, 2010; Harmon, 2015; Drezner, 2016 or original study is British Journal of Sports Medicine 48(7):667 http://dx.doi.org/10.1136/bjsports-2014-093494.286
