White Coat, Black Art·DR. BRIAN'S BLOG

Hum Stayin' Alive while a 911 dispatcher teaches you CPR. Here's how

Your chance of surviving cardiac arrest goes way up if a bystander starts chest compressions right away. It's so easy to learn, 911 dispatchers teach it to callers by phone.
In the now-famous scene from The Office, the team does almost everything wrong — except when Michael Scott (Steve Carell) does chest compressions to the tune of the Bee Gees megahit Stayin' Alive. (The Office/YouTube)

Stayin' Alive is not just an iconic disco era hit by the Bee Gees. It's also the perfect soundtrack to do chest compressions on people who collapse in cardiac arrest. Some 911 dispatchers use it to teach CPR to bystanders who call for help.   

A Rhode Island woman might have been saved had bystanders been coached on the fly.

According to a story by NPR and the Boston Globe, in August 2018, Rena Fleury collapsed while watching her son's high school football game in Rhode Island.

The circumstances were optimal for a save. Fleury was just 45 years old. Four bystanders called 911 and tried to help. There were two public access defibrillators close by.

Still, Fleury died.

One reason is that the defibrillators that could have shocked her heart back were never used. More importantly, Fleury didn't get CPR during those precious first few minutes after she went into cardiac arrest.

A review of the emergency dispatch logs showed that 911 dispatchers failed to recognize that the woman was having a cardiac arrest. Her fiance, who was with her at the time, said Fleury was talking one moment, and became unresponsive and collapsed the next. The dispatchers didn't instruct callers how to perform CPR, even though they reported that Fleury had become unresponsive.

A 2018 study published in the Journal of the American Heart Association found that 45 per cent of out-of-hospital cardiac arrest victims in North Carolina survived when bystander CPR was given. An article in the American Heart Association News said 46 per cent of those who suffered cardiac arrests outside of a hospital in North Carolina received bystander CPR.

That's a pretty good figure given the fact that overall, the chance of surviving a cardiac arrest outside of a hospital is just 10 per cent according to the not-for-profit Cardiac Arrest Registry to Enhance Survival (CARES) program. Rhode Island's survival rate is a dismal 7.6 per cent, which is ironic given that the state has a HeartSafe Community Program designed to increase the number of community members trained in CPR.

Most cardiac arrests happen at home

Those are American figures. Overall, fewer than 10 per cent of people in Canada who suffer an out-of-hospital cardiac arrest and are treated by paramedics survive and eventually return to their homes. In some communities the survival rate approaches 15 per cent. Currently, an estimated 40,000 cardiac arrests occur outside of hospitals in Canada each year. Up to 85 per cent of them happen at home and the rest in a public setting.

In this 1977 photo, John Travolta and Karen Lynn Gorney are shown in a scene from Saturday Night Fever, which featured disco songs by the Bee Gees. Hands-only CPR needs to be performed at a rate of 100/120 beats per minute like in the song Stayin' Alive. (The Associated Press)

It's easy is it to teach bystanders to do CPR. If anything, it's getting easier. A simplified CPR training program focusing on continuous chest compression led to better acquisition and retention of CPR training and better quality of chest compressions than standard CPR in lay persons. In Canada, people learn full CPR when taking a course, but chest compressions alone may be easier to teach to a lay person during a cardiac arrest. 

The people who answer 911 calls can talk a caller or bystander through performing CPR. In the U.S., there is no federal mandate to do it. It would cost an estimated U.S. $170,000 ($227,000 Cdn) to train 911 call takers in Rhode Island.

A 2007 study by researchers at the Ottawa Heart Institute demonstrated an increase in the bystander CPR rate after the introduction of CPR instruction by 911 dispatchers.

Improve survival rates

I don't know how common or widespread it is in Canada for 911 dispatchers to coach bystanders. Still, there are anecdotal successes.

In 2017, a three-month-old girl was revived after an ambulance dispatcher coached bystanders how to do infant CPR.

What needs to be done to improve survival rates in Canada?

The Canadian Resuscitation Outcomes Consortium (CanROC) is a five-year, $3 million research project designed to improve survival rates for people who go into cardiac arrest at home or in a public place. The consortium is looking at ways to get 911 dispatchers to:

  • Recognize cardiac arrest faster.
  • Understand why bystanders may be reluctant to help.
  • Use technology like smartphones to inform bystanders that someone nearby needs CPR.
  • Use foolproof ways to train bystanders on the spot.

They're even looking at ways to use drones to bring public access defibrillators where they're needed as quick as possible.

Until then, take a course in basic life support. You won't regret it. Someone may live because you took the time to learn. That someone might even be someone you know and love.

ABOUT THE AUTHOR

Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.

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