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June 18, 2012

5 tips for treating cardiac arrest

The practice of "scoop and run" — getting patients en route to the hospital as quickly as possible — might seem like the best tactic to take for cardiac arrest patients, but it actually wastes precious resuscitation time that could make the difference between life and death.

This issue and others came to light during a presentation by Las Vegas Fire & Rescue's Deputy Chief/Medical Director David Slattery at Fire-Rescue Med, a show held by the IAFC's EMS section.

From Deputy Chief Slattery's talk, here are the top five things you need to know about EMS treatment of cardiac arrest:

Time is your enemy.

Survival is extremely time-dependent. Each minute that goes by reduces the survival rate by 7-10 percent. Remember the three-phase model of ventricular fibrillation cardiac arrest.

Don't move the patient.

If the scene is safe, there's no rush to get to the hospital or even into the ambulance. All resuscitation skills are more difficult and more dangerous in a moving ambulance, and moving the patient — often accompanied by monitors, shocks, pulse checks and airway management — takes the focus away from the chest.

Breathing is overrated.

Focus on the chest. Maximize outcomes by using compression-only CPR. Each chest compression increases the difference in pressure between the sides of the heart, but every time you give a breath in CPR, the pressure difference decreases. The greater the pressure difference, the better chance the heart will begin beating again on its own.


Whether it comes from the bystander's existing knowledge, the dispatcher's guidance or your own hands, hands-only CPR is the most critical and effective tool for resuscitating cardiac arrest victims.

There is no magic at the hospital.

All the patient needs for full recovery is what you bring to the scene — yourself (safely!), your hands and, sometimes, an AED.