Bystander CPR

056002536-close-person-practicing-cpr-chHave you ever witnessed someone having an apparent heart attack when you've been out and about? I did once, while riding my bike on a local trail, and fortunately, my cycling partner, a dentist, thought to look in the man's mouth while CPR was being performed and thus removed his dentures, which had fallen down and were blocking his airway. The man survived to be transported to the hospital. On PodMed this week, Rick and I discuss a study published in JAMA Cardiology demonstrating the benefits of bystander-initiated CPR in just such circumstances, which has resulted in many more survivors among those who have an out-of-hospital cardiac arrest (OHCA).

The study looked at the impact of public health initiatives undertaken in North Carolina to improve resuscitation attempts for those who experienced an OHCA from 2010 through 2014. Almost 8300 persons had an OHCA, either publicly or at home, where CPR was initiated. The percentage of CPR initiation increased from about 28% to 41% for at home events, and from about 61% to just over 70% for those OHCAs taking place in public. Survival to discharge also improved among both groups, from 5.7% to 8.1% for at home events, and from 10.8% to 16.2% for public events. Use of automatic external defibrillators did not change for the public setting but did in at home arrests. Clearly abundant evidence for the benefit of public awareness campaigns, leading Rick and me to advocate that everyone should know CPR.

Other topics this week include Long-Acting β-Agonists (LABA) Combined With Long-Acting Muscarinic Antagonists or LABA Combined With Inhaled Corticosteroids for Patients With Stable COPD and Association Between Use of Non–Vitamin K Oral Anticoagulants With and Without Concurrent Medications and Risk of Major Bleeding in Nonvalvular Atrial Fibrillation in JAMA, and Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department: A Cohort Study, in Annals of Internal Medicine. Until next week, y'all live well.

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