The leading cause of death among Malaysians is cardiovascular disease, of which out-of-hospital cardiac arrest accounts for a significant proportion and usually results in death.
Sudden cardiac arrest (SCA) is a medical emergency when an individual’s heart stops abruptly due to multiple causes. As the heart stops beating suddenly, blood flow to the brain, lungs, and other vital organs is impacted drastically.
This condition often happens without warning, and causes the affected individual to become unconscious and stop breathing. Death is imminent, unless someone nearby takes immediate action.
CPR, or cardio-pulmonary resuscitation, is a life-saving procedure performed by a trained person for SCA victims. It consists of chest compressions and rescue breathing, delivered via mouth to mouth. For every minute that CPR is delayed, a SCA victim’s chance of survival is reduced by 10 per cent.
Before the Covid-19 pandemic, CPR was offered straight away for all out-of-hospital cardiac arrest victims. However, during the Covid-19 era, CPR is considered high-risk as it may lead to Covid-19 transmission from aerosol generation, should the victim be actively infected. Furthermore, people would hesitate to help a stranger, for fear of contracting the coronavirus.
In an attempt to raise awareness on the importance of performing CPR during the Covid-19 era, several modifications to CPR techniques have been emphasised by professional groups.
In this context, early initiation of hands-only CPR (CPR without mouth-to-mouth resuscitation) is strongly recommended. A face mask covering the mouth and nose of the rescuer and/or victim is recommended, to reduce the risk of the spread of Covid-19.
Should you, as a member of the general public, come across an individual (especially someone you know) who has collapsed, is remaining unconscious, has no pulse and is not breathing, do not panic. Start by calling 999 to get help.
With prior training, you may safely perform hands-only CPR without knowing the victim’s Covid-19 status. Evidence has proven that hands-only CPR performed by anyone on an out-of-hospital cardiac arrest victim is as effective as conventional CPR (with mouth-to-mouth resuscitation) during the first four minutes.
As recommended by the American Heart Association, you should provide hands-only CPR if you are not trained in conventional CPR, and continue until an emergency medical service provider arrives.
In fact, any form of CPR performed is always better than no CPR. If available, an automated external defibrillator (AED) should be used to complement CPR in efforts to save the victim.
Everyone can save a life by lending a hand. Get yourself registered in the Hands-Only CPR Training Course organised every month by the National Heart Association of Malaysia.
You will be exposed to different real-life scenarios in order for you to recognise the signs of SCA. You will learn how to perform high-quality, hands-only CPR, and how to use an AED.
Dr Yap Jun Fai, Prof Dr Moy Foong Ming and Dr Lim Yin Cheng are from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, and the Department of Public Health, University Malaya Medical Centre.
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