Wednesday April 25, 2018

CPR Survival Rates Lower Than Most People Think

In a scenario describing a trauma-related cardiac arrest in an 8-year-old, 71 percent predicted CPR success and 64 percent predicted long-term survival of the child

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Participants practice cardiopulmonary resuscitation (CPR) is an important life skill to know. VOA
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The majority of people believe cardiopulmonary resuscitation (CPR) is successful more often than it tends to be in reality, according to a small U.S. study.

This overly optimistic view, which may partly stem from seeing happy outcomes in television medical dramas, can get in the way of decision-making and frank conversations about end of life care with doctors, the research team writes in American Journal of Emergency Medicine.

CPR is intended to restart a heart that has stopped beating, known as cardiac arrest, which is typically caused by an electrical disturbance in the heart muscle. Although a heart attack is not the same thing — it occurs when blood flow to the heart is partly or completely blocked, often by a clot — a heart attack can also cause the heart to stop beating.

ALSO READ: 98 Percent Indians not aware of life-saving technique CPR during Heart Attack

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More often than not, cardiac arrest ends in death or severe neurological impairment. Pixabay

Odds of surviving

Whatever the cause of cardiac arrest, restarting the heart as quickly as possible to get the blood flowing to the brain is essential to prevent permanent brain damage.

The overall rate of survival that leads to hospital discharge for someone who experiences cardiac arrest is about 10.6 percent, the study authors note. But most participants in the study estimated it at more than 75 percent.

“The majority of patients and non-medical personnel have very unrealistic expectations about the success of CPR as well as the quality of life after patients are revived,” said lead author Lindsey Ouellette, a research assistant at Michigan State University’s College of Human Medicine in Grand Rapids.

Patients and family members should know about the real success rate and survival numbers when planning a living will and considering a “Do Not Resuscitate” order, Ouellette said.

“We think it is best to have the latest and most accurate information when dealing with this life-impacting decision, whether or not to undertake or continue CPR,” she told Reuters Health in an email.

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In addition to asking about general knowledge of CPR and personal experiences with CPR, the researchers presented participants with several scenarios and asked them to estimate the likelihood of CPR success and patient survival in each case. Pixabay

ALSO READ: Men with Heart Disease More Prone to Cardiac Arrest During or After Sex

Good TV, not good information

To gauge perceptions of CPR, the researchers surveyed 1,000 adults at four academic medical centers in Michigan, Illinois, and California. Participants included non-critically ill patients and families of patients, who were interviewed during random hospital shifts.

One scenario involved a 54-year-old who suffered a heart attack at home and required CPR by paramedics. About 72 percent of the survey participants predicted survival and 65 percent predicted a complete neurological recovery.

In a scenario describing a trauma-related cardiac arrest in an 8-year-old, 71 percent predicted CPR success and 64 percent predicted long-term survival of the child.

“Many people felt if a person was successfully revived, they would return to ‘normal’ rather than possibly needing lifelong care,” Ouellette said.

At the same time, more than 70 percent of respondents said they watched TV medical dramas regularly, and 12 percent said these shows were a reliable source of health information.

“Tempering unrealistic expectations may not make for ‘good TV,’ but perhaps we can get a better idea of just how these dramas may impact the views people hold about CPR and other aspects of medicine,” she said.

ALSO READ: Cardiac arrest may be fatal for those living in high rise buildings

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CPR should be part of the conversation about end-of-life care and advanced directives among families, said Carolyn Bradley of Yale-New Haven Hospital in Connecticut. Pixabay

Medical act, not miracle

“People think about CPR as a miracle, but it’s another medical act,” said Dr. Juan Ruiz-Garcia of Hospital Universitario de Torrejon in Madrid who wasn’t involved in the study. “I’m not really sure what people would choose if they knew the real prognosis of it,” he told Reuters Health by phone.

“When doing CPR at a hospital, we tend to move the family away, but we’ve created a situation where families may not be there for the final moments,” she said in a phone interview.

“Have a critical conversation with your health care provider and go with questions about what would happen during CPR,” she said. “What does it look like? What happens to my body? Who will be around? It could be the end-of-life. Statistically, it is.” (VOA)

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Heart attacks more common in winter

Every second person in the age group of 30 and above, who are already otherwise at risk, is prone to heart failure during winter, experts say

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Heart attacks are most likely in winters.

Think twice if you find alcohol the solution for keeping your body warm during winter. Medical experts caution that, apart from the common cold and cough, winter is also the time when more heart attacks occur. Every second person in the age group of 30 and above, who are already otherwise at risk, is prone to heart failure during winter, experts say.

They also say that one should not ignore irregular discomfort in chest, severe sweating, pain in the neck, arms, jaws and shoulders or shortness of breath during winter, which are major symptoms of heart failures.

Heart attacks are most likely to happen to old people in winters. Flickr

According to Vanita Arora, associate director and head of Cardiac Electrophysiology Lab and Arrhythmia Services in Max Hospital, “Everyone knows winter is the cold and flu season. But most people are unaware of the fact that it is also the prime season for heart attacks.”

She said during winter, the arteries become constricted with the fall in temperature, as a result of which the heart has to put in more effort to pump the blood. “This makes the heart stress out and it leads to a heart attack,” Arora told IANS, adding: “It is more risky for those who do not have any inkling about pre-existing heart conditions.”

Arora said that people above 30 should never indulge in overdoing anything and exhausting oneself in winter. She suggested that people, and especially diabetic patients, should avoid going for a walk in the morning on extremely chilly days and should shift their walks to the late afternoon when it is still sunny.

Arora said that too much alcohol intake during winter can cause atrial fibrillation, the most common irregular heartbeat problem called arrhythmia. In this, people tend to suffer from palpitations, fainting, chest pain or congestive heart failure.

Also Read: Heart Attack Symptoms In Women Often Misinterpreted

Heart experts said that a constant check on cardiovascular risk factors is one way to ensure that the winter season doesn’t harm one’s health. People should avoid overeating during winter and should rather eat in small quantities at regular intervals, experts suggest.

Neeraj Bhalla, senior consultant in cardiology at the B.L. Kapoor Memorial Hospital, said that as the blood’s viscosity increases with the drop in temperature, heart attacks and other coronary artery diseases increase during winter.

“Cholesterol levels fluctuate significantly with the change in season, which may leave people with
borderline high cholesterol with greater cardiovascular risk during the winter months. Apart from managing cholesterol levels, it is crucial that we keep small things in mind and do not stress the heart”, Bhalla said.

People staying in places where the seasons change very frequently are more prone to heart failures in comparison to those living in cold countries. Heart failure leads to most deaths in hypothermia – a condition in which the core temperature drops below the temperature for normal metabolism. Bhalla said to keep hypothermia at bay, it is advisable to cover yourself with layers of warm clothes. Besides this, it is advisable to take a bath only with warm water.

Alcohol should be avoided to keep body warm during winters.

Chandan Kedawat, senior consultant cardiology at the Pushpawati Singhania Research Institute, said: “In cold weather, the heart demands more oxygen because it is working harder.” Studies have shown that heart attacks and complications related to heart disease occur more frequently in the morning hours.

Research suggests that the early-morning rise in blood pressure or “a.m. surge” that occurs in most people may dramatically increase the risk of a heart attack or stroke. “In the winter, people tend to exert themselves or do more work in the morning because it gets dark earlier,” Kedawat said.

“This shift of activities to morning hours adds to the normal circadian variation (cardiac variations that recur every 24 hours) in the mornings – further increasing the heart rate, blood pressure and the hormones that lower the threshold for a cardiovascular event,” he explained. He advises that the best way to prevent such situations for people above 30 is to go for an alternate day check up to the doctors. IANS