Sudden Cardiac Arrest, A Silent Endemic

Sudden Cardiac Arrest (SCA) is the number one killer in India, killing approximately 25 lakhs people every year. As per the data revealed by Delhi Economic Survey about 150 to 250 deaths happen in the city of Delhi every single day and out of these deaths, 25 to 45 deaths occurred due to Sudden Cardiac Arrest (SCA).

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it’s not treated within minutes.

CPR or Cardiopulmonary resuscitation is a life saving technique that helps in such condition. Medically speaking discussed about this technique and its importance with a very special panel that included: Dr. SSC. Chakra Rao, Chairperson, Indian Resuscitation Council (IRC), Dr. Rakesh Garg, Honorary Scientific Director, Indian Resuscitation Council (IRC), Dr. Aditya Kumar, Honorary Director Public Relations, Indian Resuscitation Council (IRC) and Dr. Nikki Sabhrawal, Instructor IRC.

 

What is CPR and what the common man can do really at a point of time if they are witnessing someone getting a cardiac arrest?

Dr. SSC. Chakra Rao, Chairperson, Indian Resuscitation Council (IRC): Sudden Cardiac Arrest is one of the most silent killer among all the things it is not a disease as such it is something like an incident or an event that happens to a victim I don’t call them as a patient they are victims of this sudden cardiac arrest and for a population of 1.38 billion definitely there are more than 5 crore people are suffering cardiac arrest every year and if Calculated in minutes 112 victims fall prey to this sudden cardiac arrest every minute so this is the very silent killer and we have to definitely weaken it is all reversible deaths actually so how we can prevent this to train more and more people in cardiopulmonary resuscitation the cardiopulmonary resuscitation is a very simple method and actually and all these deaths which are occurring or 80% of them of them are outside the house so there is a need to train the layman and schools  mostly and I also say that even housewives should be trained because when you are in a group of trained people only you can be saved otherwise when there is nobody who knows some training it is very difficult to say but there are five methods where we can ask them or improve the training one is improve the training for all the people not only medics and paramedics to the and people in school children and make a telephone CPR you order or inspect somebody through telephone and do a CPR improve the emergency medical system and that is more important because we have a lot of inaccessible areas and in our India because of lot of differences roads congestions and all those things the ambulance cannot reach the victim within 3 minutes so we have to improve that so probably we may have to use some drones to carry the aids and another thing is the cardiac centers also have to help cardiac arrest centers means, it is not a very special device but everywhere wherever we sit even in a cafeteria  or the cinema hauls, malls, and any place where there may be a congregation of people there should be some trained people in CPR and also there should be an availability of AED for the people then we can definitely improve the survival rate by about 50% and here one thing is any delay of even one minute with decrease this survival by 7 to 10 percent so these are method which we have to follow and the Indian Resuscitation council is trying to impress upon the people and the government to bring them all.

Dr. Garg help us understand what entails in this training?

Dr. Rakesh Garg, Honorary Scientific Director, Indian Resuscitation Council (IRC): The training is very simple for lay person it has been simplified so we can teach almost around 40 to 50 people in our time around for two hours or so it doesn’t take much and it’s scientifically evidence based. It takes around 15 – 20 minutes for a group of 40-50 and another practice of five minutes which we used to do on mannequin, mannequin is like a rubber human being on which we can show them how to compress on the chest because we’re talking about CPR. It is very doable and we have been going for last so many years now and not only in India but outside India, people are learning it so I think people should come forward to learn CPR.

 

Are you using social media platforms for this purpose? If so, how?

Dr. Aditya Kumar, Honorary Director Public Relations, Indian Resuscitation Council (IRC): Yeah, yesterday itself the chairperson Dr. Rao used Facebook Live and he addressed the youth about the information regarding this CPR. What is CPR, how can we do, what is importance of CPR; various issues he address so time we use all social media platforms. More than 80% cases of cardiac arrest happens outside the hospital. Youngsters are also approaching us time to time if they would like to have sessions in College, in their schools and universities in fact we do sessions and research time to time in colleges and schools.

Dr. Nikki, what is someone would do if they see that a person right next to them stops breathing for a few seconds with suspect that they could have a cardiac arrest or perhaps you already know someone has a history of heart disease?

Dr. Nikki Sabhrawal, Instructor IRC: The first and foremost is the creating the awareness of which we’ve been talking about, what CPR is, what is the importance, timely assistance and who can do it. So you know under the IRC we have formulated the first ever Indian guidelines for doing cardiopulmonary resuscitation and this is broken up into different parts so for the laypersons there’s a compression only life support, where only by chest compressions can they save a life. Now if our government intervenes and we make it mandatory for every citizen to learn the compression only life support, this can be a life saver. Secondly is the importance of the AED.

Because most cardiac arrests occur due to this disruption in the rhythm of the heart.

Are you in touch with policymakers are you in touch perhaps the Government of India to make it mandatory?

Dr. SSC Rao, Chairperson, Indian Resuscitation Council (IRC): When it comes to governance, it is now part of the CBSE curriculum, and we will all take it seriously in CBSE medium schools following the succession of Covid. If there are private schools that can afford to buy mannequins, we will undoubtedly go to them and train them. We’ve already contacted the directors of CBSE schools, who will provide a list of them, and we’re asking our people to approach them and tell them about it, as well as train their teachers so that they can train the students and teach them how to perform CPR, and then we’ll form a very good network of school children who will act as your first responders. Many doctors have approached the government, and we have already made CPR training necessary in some medical universities, and we will make it mandatory for NSS and NCC camps and other similar groups, resulting in a very large number of people who have learnt the procedure.

Dr. Garg, tell us about what you are advocating to the government and policymakers of our country and what are your advice for the youth to increase the awareness about this life saving technique?

Dr. Rakesh Garg, Honorary Scientific Director, Indian Resuscitation Council (IRC): I agree if with some policies if it can be mandatory in dome schools and colleges then its absolutely fine so schools should add this in their curriculum and we have already taken an initiative where it is a part, so I think the budding students were ambitious so if they are being thought then it obviously will be helping our community on the other side even if I teach somebody the necessary things about doing CPR and give them a certification but if they see somebody collapsing on a road and it isn’t their inner feeling wants to help them by giving CPR, it’s the big issue that’s why through your channel and media like you are definitely helping us in creating awareness its just not creating awareness but also inner consciousness which should be generated that the country, community and the society has given us so many things to us so why can’t we give something back to the community, so I think this kind of inner feelings should come out for the community from our side and we should not only learn it which we are providing a platform but also be ready to help in various formats and  various platforms including the MNC from medical community including the government is working and supporting us a lot and CBSE is already taken an initiative so I think a big work is done all over and channels like you and the enthusiastic journalists are helping and supporting in this noble cause of creating awareness.

How are you trying to bridge it with people in rural areas where access to a doctor, even primarily healthcare maybe a few hours away?

Dr. Aditya Kumar, Honorary Director Public Relations, Indian Resuscitation Council (IRC): Actually the life donation is very big donation its an age old saying in Indian culture so people know all these things already so if we take the example of other countries like Europe, America, Singapore, Japan  they had included the basic CPR, in their syllabus a long time ago but now due to efforts of Indian recession council  we have get it included in CBSE and now we are trying to include it in local level and regional level because students go to school it they will learn through schools then it will impress them more rather than saying to them but other than that in recent times we are trying time to time through local newspapers or news channels or local rallies. We are trying our level best because our organization was started three years ago IRC. Afterwards on 16 October 2019 we had trained 7 lac people around the country free of cost which is a record in itself  the world bodies across the globe really appreciated it like anything, because we are trying our level best but in recent times in Covid situation we are focusing upon TOT,  that is teaching of trainees. We are making a network of trainers who will teach further to all the people when demand comes around the country but the rural divide is there so we are trying our level best through various awareness campaign and media like you.

How can someone save a life with bare hands?

Dr. SSC Rao, Chairperson, Indian Resuscitation Council (IRC): there is no need for expensive equipment. The two bare hands can save a life. When you notice a person on the ground fallen unconscious and tap on his shoulders, call for help if he doesn’t respond. You can dial 108 on your mobile and inform about your situation and place and don’t disconnect unless asked. Meanwhile, open the shirt and identify the xiphoid process that is located at the lowermost part of the sternum and measure two inches of distance with your finger. Now put your hand on the chest and interlock with the other hand. The heel of the hand should be on the sternum and then go on compressing for 120 compressions per min with 5-6 cm depth. This will definitely give the count of the blood to the brain and can save the patient. Meanwhile the AED will be brought. AED tells whether or not the patient needs to be given shocks. Henceforth, that patient can be transferred to the nearest medical facility.

Dr. Nikki would you like to add something to it?

Dr. Nikki Sabhrawal, Instructor IRC: These training programs need to be started at the school and college levels. It might be that someday your family member might be collapsing in front of you, you can do something to save their life. We have trained 1000s of individuals. If AEDs are available in Flights and malls and should be made available in schools, colleges and libraries also. If we don’t have an AED we continue with chest compression and that will help. This is my message to everyone that the training is available free of cost. People who are selling this equipment have saved many lives. We are training people, you should have the eagerness to come forward.

Should a person who has perhaps watched the videos but not sure or trained, perform a CPR?

Dr. Nikki Sabhrawal, Instructor IRC: Some effort is better than no effort at all. This process can be learned by everyone. Call for help, but continue with the chest compression till you get help.

Concluding the debate, Dr. Garg what would be your final message?

Dr. Rakesh Garg, Honorary Scientific Director, Indian Resuscitation Council (IRC): If we can save a life from sudden cardiac arrest, we have given something back to the society. I think the training program that Dr. Nikki talks about is a great initiative and I think that every individual should can get the training.

Dr. Nikki what are your concluding remarks?

Dr. Nikki Sabhrawal, Instructor IRC: Just like the principal of a school, president of RWA or the manager of a mall is responsible for running the show properly, it should be a priority to run these camps. We have done it here in Chanakyapuri, and in our hospital and trained 4-5 thousand people including the security staff and non medical people working at the hospital. Charges of these institutions should make it a part of their curriculum.

Dr. Aditya what is your message to the youngsters watching the show?

Dr. Aditya Kumar, Honorary Director Public Relations, Indian Resuscitation Council (IRC): Only 2% of the population is being trained for CPR in our country. If we talk about other countries, more people are aware about it because it is a part of their syllabus. So people should come forward to het the training as we are providing it free of cost. They can also visit our website which is www.cprindia.com and get registered.

In today’s times we are seeing so many people lose their lives due to Covid and it is a message to everyone that let’s not lose a life due to a cardiac arrest. As Dr. Garg said, making something mandatory is not the way. We need to realize the importance of this by ourselves. Get yourself registered at the website and save at least one life.