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CPR Awareness In DC

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In this paper I look at different possible methods that could be used in Washington DC to boost CPR awareness and increase the survival rate for out-of-hospital cardiac arrests.
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  Eric Gallager CPR and First Aid, Spring 2011Increasing CPR Awareness in Washington DCCPR (cardiopulmonary resuscitation) is a vital skill for people to have. It can savelives when performed properly in emergencies such as cases of cardiac arrest or heartattacks. While these often happen in hospitals where everyone is trained to give CPR,they more often occur outside of the hospital where receiving CPR depends on the CPR awareness of the people around the victim. Unfortunately, Washington DC is not a veryCPR-aware city. The survival rate of out-of-hospital cardiac arrests is low here, at a level below 2% (Graham 2011). This is below the national average of 6% (VirginiaCommonwealth University 2009), and nowhere near the national high seen in Seattle(Gever 2008). The outlook does not look good for someone in need of CPR on the side of the street in this city.What is to be done about this state of affairs? There already exist some efforts toimprove these conditions. For example, ReStart DC has a program in which it is trying todistribute AEDs (Automated External Defibrillators) (ReStart DC 2011). AEDs are anessential part of the CPR process, especially in cases of cardiac arrest. One hoping toincrease CPR awareness in DC could decide to support the efforts of ReStart DC. Also,the American Red Cross has a CPR Awareness Week every year (Red Cross 2008).Efforts to increase CPR awareness in DC could be directed at making sure that the localAmerican Red Cross chapter here in DC participates in this week at least to the extent towhich other Red Cross chapters around the US participate in it.While these efforts are all well and good, it remains that they primarily take placethrough private institutions. Perhaps there are some public policy solutions to this problem? There has been research done about this issue, and while none of this research1  Eric Gallager CPR and First Aid, Spring 2011was specifically about Washington DC, many of the findings would be applicable to it.Different pieces of research make different suggestions, so it would be good to examineeach one in turn. Some of the research on this topic is somewhat old, so it would makesense to start with the earliest and move forward in time to see how the recommendations progress. One early piece of research on this topic studied out-of-hospital cardiac arrestsin New York City (Lombardi et al. 1994). New York City is a large urban area, and manyof the suggestions included in this research apply to large metropolitan areas in general,so they can also be applied to DC. The study attributes poor out-of-hospital cardiac arrestsurvival rates in urban areas to EMS systems with a slower chain of survival than those insuburban and rural areas (Lombardi et al. 1994). This may not seem like a public CPR-awareness problem, but it can be construed as such if one considers that CPR is required before EMS arrives (assuming the public even knows to call them), and that publicawareness of the need for EMS providers to be able to perform their jobs can cause said public to make way for EMS more quickly. One specific recommendation the studymakes is to train more uniformed services as first responders (Lombardi et al. 1994); thisgoes along with the general goal of raising CPR awareness, as having more firstresponders means the chance of someone in an emergency receiving CPR if they need itis greater. Hopefully these recommendations have been put into place in DC by now.After this 1994 paper, many other researchers did studies about out-of-hospitalcardiac arrest survival rates. Eventually there were so many of these studies that it became necessary to do meta-analysis (Sasson et al. 2010). While this review did notinclude any studies that looked at Washington DC, many of the studies it did cover looked at cities of similar sizes, so its recommendations should still be applicable. One of 2  Eric Gallager CPR and First Aid, Spring 2011the conclusions it came to was that since most of out-of-hospital cardiac arrests occur with people nearby, bystander CPR has value, and that “focused strategies designed to boost rates of bystander CPR” should be employed (Sasson et al. 2010). This coincideswith the goal of raising CPR awareness here in DC. Unfortunately, the authors do notdescribe the exact strategies that ought to be used to boost these rates of bystander CPR.Still, it shows the importance of spreading CPR awareness in the first place.Besides publishing research supporting increased CPR awareness, medical professionals have also been publishing opinion pieces to the same effect. One recentarticle in Emergency Medicine News supports this viewpoint (Brady et al. 2011). Somemethods suggested in this article include teaching hands-only CPR, which is easier for  bystanders to provide than regular CPR, and making sure AEDs are ready to be used incases of emergency (Brady et al. 2011). This second point about making AEDs more publicly available coincides with the goals of ReStart DC, as mentioned previously(ReStart DC 2011). In general, the advice in this article could all be readily applied toWashington DC.There are many things that can be done that coincide with the goal of raising CPR awareness here in Washington DC. There are private institutions that have efforts that areharmonious with this goal, from ReStart DC’s efforts to distribute AEDs, to the CPR awareness week put on by the American Red Cross (which includes its DC chapter). Inthe public sphere, more public officials can be trained as first responders, and theefficiency of EMS systems can be optimized. Hands-only CPR can be taught to peoplewho would not learn full CPR. DC residents and the DC government should consider allthese options and choose the ones that would be most effective for our city.3  Eric Gallager CPR and First Aid, Spring 2011Works Cited"ReStart DC - About Us." 2009. Web. 5/8/2011 <http://www.restartdc.net/about.html>."American Red Cross: CPR/AED Awareness Week." 2008. Web. 5/8/2011<http://www.redcross.org/preparedness/BRCR/>.Brady, William J., Sarah Morris, and John P. Benner. "Viewpoint: Out-of-HospitalCardiac Arrest: Getting Back to the Basics."  Emergency Medicine News 33.4(2011): 5/8/2011. Web. 5/8/2011.Gever, John. "Medical News: Survival Rates After Out-of-Hospital Cardiac Arrest VaryWidely - in Emergency Medicine, Emergency Medicine from MedPage Today."9/23/08 2008. Web. 5/8/2011<http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/11012>.Graham, Brandon. "CPR Lecture." CPR and First Aid Class Session 1. GeorgeWashington University. GWU Hospital, Washington, DC. 27 Feb 2011. Lecture.Gulli, Benjamin, Jon R. Krohmer, and Stephen J. Rahm.  Professional Rescuer CPR .Third ed. Sudbury, MA: Jones and Bartlett Publishers, 2007. Print.Lombardi, Gary, E. John Gallagher, and Paul Gennis. "Outcome of Out-of-HospitalCardiac Arrest in New York City: The Pre-Hospital Arrest Survival Evaluation(PHASE) Study." The Journal of the American Medical Association 271.9 (1994):5/8/2011. Web. 5/8/2011.Meyer, Alastair D., et al. "Out-of-Hospital Cardiac Arrest."  Medical Journal of Australia 2000.172: 5/8/2011. Web. 5/8/2011.Sasson, Comilla, et al. "Predictors of Survival from Out-of-Hospital Cardiac Arrest."  Journal of the American Heart Association 2010.3 (2010): 5/8/2011. Web.4  Eric Gallager CPR and First Aid, Spring 20115/8/2011.Virginia Commonwealth University. "Survival Rates From Out-of-Hospital CardiacArrest Nearly Double." 11/17/09 2009. Web. 5/8/2011<http://www.medicalnewstoday.com/articles/171108.php>.Wikipedia contributors. "Cardiopulmonary resuscitation." Wikipedia, The Free Encyclopedia . Wikipedia, The Free Encyclopedia, 16 May 2011. Web. 17 May 2011.<http://en.wikipedia.org/w/index.php?title=Cardiopulmonary_resuscitation&oldid=429465057>.5

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