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 lifesaving procedure performed by a trained person on SCA victims. It consists of chest compressions and rescue breathings delivered from mouth to mouth. For every minute that CPR is delayed, an SCA victim’s chance of survival reduces by 10%.
Before the COVID-19 pandemic, CPR was offered straight away to all out-of-hospital cardiac arrest victims. However, during the COVID-19 era, CPR is regarded as a high-risk procedure to acquire COVID-19 infection due to the components of CPR being able to generate aerosol among infected COVID-19 patients. Besides that, people hesitate to help a stranger for fear of contracting the COVID-19 virus.
In an attempt to raise awareness of the importance of performing CPR during the COVID-19 era, several modifications to CPR techniques have been emphasized by professional groups. In this context, early initiation of “hands-only CPR” (CPR without mouth-to-mouth breathing) is strongly recommended to the public. A face mask covering the mouth and nose of the rescuer and/ or victim is recommended to reduce the risk of COVID-19 spread.
So, if you as a general public member encounter an individual (especially someone you know and love) collapsing in front of you with no heartbeat, 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 a public member on an out-of-hospital cardiac arrest victim is as effective as conventional CPR (with mouth-to-mouth breathing) during the first 4 minutes. As recommended by the American Heart Association, the public member should provide hands-only CPR if he/ she is 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 saving the victim.
Everyone can save a life by lending their two hands and you can make a difference in someone’s life. Do get yourself registered in the “Hands-only CPR Training Course” organised monthly by the National Heart Association of Malaysia. In the course, you will be exposed to different real-life scenarios to help recognize SCA. You will learn how to perform high-quality hands-only CPR and how to use an AED.
CPR saves lives.
Learn to do it well and right.
Give the victim a new chance of life.
This write-up was prepared by Dr Yap Jun Fai (DrPH candidate), Professor Dr Moy Foong Ming and Dr Lim Yin Cheng from the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
This write-up is also published in the CodeBlue, New Straits Times, Utusan Malaysia, and Berita Harian.
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