Casale

Casale

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Rowan, my 4-year-old granddaughter loves playing doctor (surgeon?) with her stuffed animal friends as patients. For the life of me I can’t understand where she gets that.

Perhaps her real pink stethoscope, mini scrub suit and mask or set of examination instruments inspires her. Recently though she added her version of CPR, sort of chest compressions and rescue breathing to “Lambie’s” last visit to Rowan’s office. I don’t know where she saw that but I am pretty proud of her observational skills.

It’s also reminded me to discuss with you a recent evolution in the way we treat cardiac arrest.

A startling health story out of the world of professional sports has made headlines recently. Following his shift on the ice, Jay Bouwmeester, a 36-year-old defenseman for the NHL’s St. Louis Blues, collapsed on the bench. He suffered what was reported as a “cardiac episode” and was revived by team medical staff using an automated external defibrillator (AED).

Conscious and alert when transported to a hospital, Bouwmeester underwent a procedure to implant a cardioverter defibrillator, which was a success, according to NHL.com. Cardiac arrest is the sudden loss of heart function during which the heart pumps inefficiently or, worse, not at all, and it can be caused by heart disease, congenital heart defects and arrhythmia among other conditions.

The fact that Bouwmeester’s life may have been saved by someone on the spot is the basis for a new set of guidelines for the treatment of cardiac arrest.

Until recently, conventional wisdom dictated that a patient suffering cardiac arrest should be rushed to a hospital for treatment to have the best chance of surviving. But research has consistently demonstrated that the opposite is the case.

Those in cardiac arrest have the best chance of survival if first responders administer cardiopulmonary resuscitation (CPR) or use AEDs at the site of the cardiac arrest.

A recent essay penned by my colleague and emergency medicine physician Dr. Essie Reed-Schrader details the importance of this research and how Geisinger has adopted new policy based on what’s been learned.

Based on the knowledge that patients who suffer cardiac arrest outside of a hospital rarely live if their hearts have not been restarted or regulated at the scene, the Pennsylvania Department of Health has revised protocols for emergency medical services professionals.

The new guidelines instruct first responders to use life-saving interventions, CPR and defibrillation, onsite to significantly improve survival rates for cardiac arrest patients. The new standard will empower emergency medical technicians and paramedics to start and regulate hearts in the field and become the first and most important defense against cardiac arrest.

But beyond shifting the delivery of the first wave of treatment from emergency department nurses and physicians to first responders, updated recommendations encourage bystanders to get involved.

Emergency medical professionals are often not the first people on the scene, and statistics shows it’s a rare occasion when onlookers in the public administer CPR.

If this trend changes, more lives can be saved. Starting CPR immediately can either revive a patient or increase the changes that EMS providers will be able to revive a patient once on scene. Even when not expertly performed, bystander CPR is better than none at all. And for those who might be concerned that novice CPR could be a source of liability, Pennsylvania’s “good Samaritan laws” offer layers of protection for untrained people who offer help with the pure intent of saving a life.

These new guidelines could be groundbreaking, but it will take whole communities to carry out this method of treatment. Physicians, nurses, emergency medical professionals and members of the general public will all need to be educated and then urged to act when a neighbor is in need.

Especially if someone in your family has heart disease, learning CPR is a wonderful way to say, “I care about you.” I hope you’ll never need to use your skills but it’ll be reassuring to have them.

Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via [email protected]. For information on alternative treatment for atrial fibrillation, visit https://geisinger.cc/2E2N8n8