Did You Know This About Cardiac Arrest?
One of my weekly TV guilty pleasures is watching Grey’s Anatomy. It seems like each week at least one patient has a cardiac arrest. The staff pulls out the crash cart, someone yells “clear” and the patient gets shocked back into a normal rhythm. If only it was that easy!
According to the American Heart Association, about 475,000 Americans die each year of sudden cardiac arrest. The majority of these events occur outside the hospital making it important to be able to immediately administer cardiopulmonary resuscitation (CPR).
Common causes for cardiac arrest include coronary artery disease, structural problems with the heart, exposure to toxins such as drug overdoses, and trauma.
You may be surprised to know that some sudden cardiac arrests do not respond to a defibrillator (a device that delivers an electrical shock to the heart). Two types of shockable heart rhythms respond to the use of defibrillator when the rhythm disturbances are caused by a problem with the electrical system in the heart. They include:
1: Ventricular fibrillation: This heart rhythm occurs when the heart beats with a rapid and erratic electrical impulse resulting in blood not being pumped out of the heart. This is a common cause of out-of-hospital cardiac arrest.
2. Pulseless ventricular tachycardia: In this case, the heart rhythm shows a wide, regular, but very rapid rhythm. The patient does not have a pulse and needs to be shocked to “reset” the heart.
Rhythms that are non-shockable include:
1: Asystole: (complete absence of electrical activity)
2: Pulseless electrical activity: (monitor shows electrical activity, but there is no pulse).
In these two instances, the heart’s electrical system is working properly, but the heart has stopped due to another medical issue such as loss of blood, too much fluid taken off in dialysis, or lack of oxygen.
The survival rate of out-of-hospital cardiac arrest is only about 10%. Women have a lower percentage of shockable rhythms and a lower chance of survival of out-of-hospital cardiac arrest.
Older patients in a nursing home have less than a 4% chance of surviving a cardiac arrest. Despite this poor outcome many long term care residents fail to have a do not resuscitate (DNR) order. A DNR order is put in place to inform the medical staff that they should not attempt CPR if the resident stops breathing or does not have a heartbeat.
When I meet a new client in their home or in a retirement community I always ask if they have made a decision about what to do if their heart would stop. If they are still undecided, I educate them on the pros and cons of being a “full code” vs DNR.
I would also encourage adult caregivers of aging parents to have that discussion with their family medical provider. When clients are given information on actual survival rates they are better able to make an informed decision.
If you have questions about a sudden cardiac arrest or other health-related questions, I’m here for you. I offer free 15-minute consultations and can provide information to help you make decisions about your health, and am happy to help every step of the way! Contact me today.