Hello, welcome everybody. This is Dr Bolad, board certified physician in Cardiology, Interventional
Cardiology and Internal Medicine. I am here to help you with all the information you need
for your heart health and informing you about the latest treatments in cardiology. If you are new to
this channel then definitely consider hitting the subscribe button below and switch on the
notification bell so you don't miss any new videos that I post. Today I will talk to you about Sudden
Cardiac Arrest abbreviated as SCA and how to improve survival by performing basic life support
in the form of Cardio-Pulmonary Resuscitation abbreviated as CPR. The exact incidence of sudden
cardiac arrest in the United States is unknown but estimates vary from one hundred and eighty
thousand to four hundred and fifty thousand per year. The most common cause of Sudden Cardiac
Arrest is Heart Attacks leading to the development of deadly irregularity of heart beating
medically known as Ventricular Fibrillation. This is Shown in this image in the lower
tracing reflecting fast irregular heartbeats originating from the lower part of the heart.
Despite the development of cardio-pulmonary resuscitation, electrical defibrillation
and other advanced resuscitation techniques, survival after out of hospital sudden cardiac
arrest is only 10 to 15 percent. There are a few steps that have to be systematically followed.
These steps constitute what we call the Chain of Survival as shown here in this image. Your role
as a rescuer is to execute the first four steps of the chain until arrival of help from the emergency
medical services. Step number one recognize sudden cardiac death or recognize cardiac arrest.
Rapid recognition of sudden cardiac arrest is the essential first step of successful resuscitation.
If you witness a person collapse or come across an apparently unresponsive person you should
confirm unresponsiveness by tapping the person on the shoulder and shouting "are you alright".
If the person does not respond then check for arterial pulse in the neck and breathing.
If these are absent then you should move on to step number two which is to call for help. If
you are on your own then call the emergency number from your cell phone. This is 911 in
North America, 999 in the United Kingdom and the Republic of Ireland, 112 in Europe and other
numbers in different countries. You should clearly state the emergency as Sudden Cardiac Arrest
and give your location. Then you should move on to step number three which is performing high quality
cardiopulmonary resuscitation, CPR. Coronary perfusion pressure and return of spontaneous
circulation are maximized when excellent chest compressions are performed. The mantra of the
American Heart Association is push hard and push fast on the center of the chest with the goal
to maintain the rate of chest compressions at 100 to 220 compressions per minute and compress
the chest at least five centimeter which is two inches but no more than six centimeter which is
2.5 inches. With each down stroke allow for their chest to recoil completely after each down stroke.
You should also minimize the frequency and duration of any interruptions and should not
exceed 10 seconds. The rescuer places a palm of one hand in the center of the chest
over the lower portion of the sternum and the palm of the other hand on top of the first. If the
patient is not breathing then you should provide ventilation as well. You should first extend the
neck to open the airway as shown here making sure there is no blockage and then deliver ventilation.
Proper ventilation for adults include two ventilations after every 30 compressions and each
ventilation over no more than one second. Provide enough air to observe the chest rise and give one
asynchronous ventilation every 6 to 8 seconds giving a total of about 10 breaths per minute
If a portable defibrillator termed Automated External Defibrillator
or AED for short is available, then proceed to step number four. The AED
should be attached to the patient as shown the AED switches on automatically once it is opened.When
attached you should interrupt the resuscitation for a few seconds to allow the defibrillator to
analyze the heart rhythm and the AED will talk back to you and inform you about what you should
do. It might tell you to step away as it is about to deliver an electric shock or it might tell you
to resume chest compressions and ventilation. It is essential to minimize delays and interruptions
in the performance of excellent chest compressions, therefore cardiac rhythm analysis
should only be performed during a planned interruption at the two-minute interval
following a complete cycle of cardiopulmonary resuscitation. Following any interruption,
sustained chest compressions are needed to regain pre-interruption rates of blood flow
You should continue resuscitation until the arrival of the emergency
medical team who will take over resuscitation.
From that point onwards your role as a rescuer is to maintain the circulation by chest compressions
and maintain oxygenation by ventilations until the arrival of the emergency medical personnel
To recap, I show again the steps of the Chain of Survival. Confirm that sudden cardiac arrest
occurred by asking for response from the patient by checking the carotid pulse in the neck and
checking for breathing. If these are absent then call for help from your cell phone or ask a
bystander to call for help from his or her phone. Then perform CPR by providing just compressions at
100 to 120 compressions per minute, compress the chest at least five centimeter which is two inches
and allow the chest to recoil completely between each compression. Minimize the frequency and
duration of any interruption. Each ventilation should be delivered over no more than one second
and must be delivered without excessive force, only enough volume to confirm chest rise. If a
portable AED defibrillator is available then it should be attached to the patient and the
instructions delivered by the AED followed. Early defibrillation is critical to the survival
of patients with ventricular fibrillation. Continuing the basic life support CPR until
arrival of an emergency medical team who will take over resuscitation from this point onwards
If you have any question about what I presented to you today or any cardiology question in general
then subscribe to my channel, share your question in the comment section below and I will reply to
you. If you have a question that you would not like to share in public, then subscribe to this
channel, follow me on Twitter @DoctorBolad and then send me a private Twitter Direct Message
and I will reply to you. Please like and share this video with family and friends.
this is Dr Bolad helping you with your heart health, thanks for watching and talk to you soon
you