Healthy Outlook

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A man sagged to the ground in front of a coffee shop in Danville two years ago, showing signs of cardiac arrest. He faced a dire emergency — but not alone.

Bystanders recognized the crisis. Somebody called 911 immediately. Somebody else began cardiopulmonary resuscitation. So many people knew what to do that, when paramedics arrived, the crowd around the victim was clapping rhythmically to help those delivering the CPR keep time with their chest compressions.

Not every victim of cardiac arrest gets lucky enough to collapse in front of knowledgeable and willing passers-by. And not every victim survives, even after receiving timely CPR. But this victim's chances doubled — maybe tripled, according to some research — because bystanders got involved. And he survived.

What are the chances of that happening in your neighborhood? Regardless of where you live, the answer is, "Not high enough."

More people than ever are learning CPR. But only 32% of all cardiac arrest victims receive CPR from a bystander, according to the American Heart Association. From my experience as medical director of Contra Costa County Emergency Medical Services, I know that far too many people avoid helping to save a life because of misconceptions.

When people think about CPR, they think it is difficult. They think about responsibility: What if the victim dies? And they think about hygiene, naturally, because they believe that doing CPR means placing one's mouth on a potentially sick stranger.

Word is still filtering out to the public about a radical shift in how we teach CPR, enacted nationally just a few years ago. We now ask the public to practice "hands-only" CPR, a method so simple to learn that we now train middle-school students to perform it effectively, and to teach their parents. Anyone can learn the basics in five minutes: If someone collapses, is unresponsive and stops breathing normally, use both hands to push hard and fast on the center of their chest.

Hands-only CPR is almost as effective as traditional CPR, and in practice it is more effective because more people are willing to do it.

We and our partners in the county's HeartSafe Community program made this change locally to encourage participation. In Contra Costa we've seen the rate of CPR done by bystanders increase by 37% in the last 4 years, and overall survival from sudden cardiac arrest has increased by 17%.

CPR learners still share common concerns, but they're the kind we can address in training, rather than matters of personal discomfort. People wonder, for example, if hard compressions can hurt a patient. (Short answer:

Just about no one fortunate enough to survive cardiac arrest complains about a broken rib.)

Nearly 383,000 cardiac arrests occur annually outside of hospitals in the United States. Only about 8% of those victims survive. Those who do typically get help quickly from bystanders. If we increase the number of CPR-trained people in a community, we increase the chances that one will be nearby when another community member experiences cardiac arrest.

It's hard to fathom why anyone would consciously avoid CPR training these days. The more we put off such a small chore, the more we may regret it.

Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.