Cardiopulmonary resuscitation or CPR is a famous procedure that saves the lives of those with trouble breathing or those under sudden cardiac arrest. Most of the time, there are a lot of myths and misunderstandings that the untrained laymen would not understand regarding CPR. Here are some of the questions:
Should the force of pumping be enough to break the ribs?
Absolutely not. The compression should measure at least an inch or two into the chest area of the victim, but that does not entail breaking the ribs to get there. The chance of broken ribs increases with the lack of training of someone administering CPR, although a cracked rib happens more often with older patients, as the bones are more brittle and susceptible to breaking from pressure. People are convinced that administering CPR to a skinny person will have a greater chance of breaking their ribs, but this is not the case. Age, not weight, is the only factor that leads to bone damage during CPR.
Is CPR always successful?
As a matter of fact, CPR is mostly unsuccessful. This fact is accepted by those who undergo CPR training. CPR does not necessitate the revival of someone with a stopped heart, but it should be done nonetheless. Those suffering cardiac arrest are already considered as “clinically dead” so administering CPR should always be done to increase chances of revival.
How do you know if CPR is working?
Some signs that indicate that the CPR administration is working is the rise of the chest of the patient. This means that giving mouth-to-mouth resuscitation gives stimulation to the lungs. The air a person administering CPR exhales is composed of 16% oxygen, which is close to the 20% that is normally absorbed through regular respiration. Continuous administration of CPR is the only thing that ensures survivability and increased chances of revival.
What is hands-only CPR?
Hands-only CPR is the administration of chest compression CPR, removing mouth-to-mouth resuscitation in the process. This is done when the person administering CPR is unwilling or not confident in performing ventilation via mouth. Hands-only CPR also occurs when there are 2 people performing CPR, in which one person performs the compression only on the victim while the other performs breathing into the victim’s mouth. In the case of 2-person CPR, the ratio of compression to resuscitation is still 30 compressions to 2 resuscitations, repeated until revival.
When should I start and stop performing CPR?
CPR is an immediate reaction to revive an unconscious person. An individual should start performing CPR as soon as signs of breathing has stopped in a victim. If unable to perform CPR, a 911 emergency dispatcher can run through the process for the one performing. There are no consequences whatsoever for someone performing CPR as they are covered by the Good Samaritan Law and the administration of CPR is always more important over anything else.
For those that are interested in being a helpful citizen, trainings are available to learn the proper and effective CPR techniques for the event when a person will need your help.
The influence that is brought by both television and films cannot be denied. Back when the internet was still on its way, the motion picture industry has conquered majority of the consumers. This is evident in the staggering number of studios that was built back in the day. The industry shapes lives and even fosters culture up until today. There are times, however, when the portrayals done by actors on the screen are not properly in sync with what really happens in real life. Administering CPR is one of those things.
There are numerous hospital dramas that are watched by numerous viewers, and every now and then a patient that needs CPR or AED is incorporated into its plot for the progression of story. Now this is where the crucial misconceptions happen.
Normally, when an out-of-hospital cardiac arrest happens, people who can administer CPR goes to rescue the patient. This is what really happens in real life: CPR is administered while somebody calls an ambulance, CPR is continued until AED is available. You wouldn’t hear someone yell out “I know CPR, I’ve seen it on TV!”, and give compressions to the victim. Unfortunately, this scene is always portrayed by the actors on the screen, and what’s even more disturbing is the quality of compressions that they give. The American Heart Association has given emphasis on the quality of compressions that one should give in place of breathing for the patient. Most of the time, the actors on screen do not press enough on the victim’s chest to give quality compressions. And this “act” is watched by several people who may or may not have enough knowledge on the importance of CPR as it is.
Another point worth mentioning is the proper use of AED. One of the most common setting of a hospital drama is the emergency room where a critical patient will either make it alive or not. This is natural, in a real hospital setup but for plot reasons on screen, this is a favorite. Most of the time, actors who act as doctors would “rub” the pads of the AED before giving a patient an electrical shock. Others call this a “good luck rub”; however, it does not really do anything to increase the effectivity of the AED. In fact, the rubbing of the pads can even damage the device. Also, the placement of the pads when giving a shock also differs from the practice that medical professionals do in real life. Notice how the pads are placed parallel each other across a patient’s chest? That’s not how you do it. The National Institute of Health instructs the placement of one pad on the right center of the person’s chest just above the nipple and the other pad slightly below the other nipple and to the left of the rib cage. And one thing that is the mother of all misconceptions of CPR and AED: the flat-line. Medically speaking, you cannot revive a patient with a flat-line. An AED can only go as far as correcting the irregular heartbeat, not restart a heart. The only way to treat a patient with a flat-line is through CPR.
Of course, you can still continue to watch these medical dramas that you see on TV but it is vital that you know this information so you can decipher an act for a fact. Learning CPR and AED from television or online videos for that matter can only help you so far but taking proper training from credible professionals such as Citywide CPR can give you real facts that you can use in real-life.
Everyone loves a good drama. No matter the medium—television, radio, magazine, internet—most people like to see the overused theme of man’s struggle and his rise above the odds. This is why medical dramas and its counterparts are well-loved and well-received by the audience.
One flaw that is seen on almost any medical drama though is the revival of a patient with flat-line. Miraculously, a doctor will be sending electrical charges to a patient with no heart rhythm and his heart will restart. Viola! The patient lives to tell the tale. This is something that medical professionals find either absurd or highly entertaining because in reality, you cannot revive a flat-line patient using electrical shocks.
It is important first and foremost that we understand how our heart works before the flat-line norm is discussed. For our hearts to function, shocks must be given to it so it would produce contractions that would then send blood to the brain and other vital organs of the body. To summarize without the intricacies of physiology, the electrolytes (potassium, sodium and calcium) are responsible for reaching the right amount of charge so the heart can send out its shock known as depolarization in the Sinoartrial node (SA node). From this shock, the atria contracts that is the upper part of the heart while the ventricles receive the blood from the upper part, thus what we now know as the pulse.
In a cardiac arrest, a patient has no pulse and would need an electrical shock. There are a number of heart rhythms that occur during a cardiac arrest; however, the most is Ventricular fibrillation. Remember the electrolytes that create the charge for a shock in the SA node? When the SA node fails to create this beat, other cells within the heart “attempt” to produce the necessary shock to make a beat. This results to simultaneous shocks from different directions to numerous areas of the heart, creating an erratic beat that resembles that of a heart having a seizure. The goal of the shock from an AED is to create an electrical charge that is stronger than the ones generated by the other cells to push all the electrolytes out of the cells at the same time while hoping that the normal operation of the heart takes over.
So when a patient is in asystole or having a flat-line, there are no electrolytes inside the cells to shock. What you would be doing is shocking an empty vessel and you would get nothing more than a flat-line. The gist is that you need to have an electrical impulse, no matter how little it is, to work with. Shocking a patient that had asystole would only burn his heart with the heat created from the shock.
In the end, it always pays to be a smart viewer. You simply cannot take all information without giving the benefit of the doubt. If you get an information and want to be sure of it, you can research about it. If you really want to know more about CPR and AED, instead of relying on medical dramas, you yourself can learn how to properly administer and even when to administer CPR or AED by undergoing training. Certified training courses such as the ones provided by Citywide CPR is a more relevant way of learning your first aid, with no flawed information and facts.
Cardiac arrest is the culprit behind a massive number of deaths worldwide. Despite of the many advancements in technology this issue still persists to attack people, no matter the race, gender and age. Nevertheless, medical efforts on addressing this condition cannot be overlooked. Over the years, the manual equipment used to revive a patient’s heartbeat has now become automated, thus the advent of Automated External Defibrillator or AED.
From Manual Defibrillation To Automated External Defibrillation: The Advancements
Back in the days, defibrillator is only available on certain areas such as hospitals and clinics. This is a matter of concern since cardiac arrests are statistically likely to occur outside the vicinity of hospitals. Although proper administering of CPR can greatly increase the chances of survival of a cardiac arrest patient, he must still be brought to a hospital for defibrillation—the process of applying an electric shock to the chest.
Manual defibrillation, the traditional form, requires complex skill by the person using it. One of the features of this machine is its ability to read heart rhythms, referred to as electrocardiogram (ECG). Therefore, the operator of the machine must have knowledge on reading and interpreting heart rhythms to recognize abnormalities that require the use of defibrillation. Once the need for the electric shock is acknowledged, the operator should manually operate the particular model of defibrillator available.
Through the years, the machine has become more portable and Emergency Medical Service (EMS) can now use the equipment event outside hospital boundaries. This is a significant step forward on addressing ventricular fibrillation cases outside hospital bounds. During this time, the equipment is brought to the patient and is administered by carefully trained and supervised paramedics, instead of the other way around.
Computers that are invented forty years earlier has become much smaller during the 1980s. It is also during this period that the defibrillator everyone knows has become computerized as well. Coined as AEDs, these devices greatly reduced the complexities that the traditional defibrillator required. An AED is capable of reading and interpreting a person’s heart rhythm and can instantly deliver shock to the patient with minimal input from the operator. This feature made it possible for people who do not have a medical background to use AED on a cardiac arrest patient.
As the complex steps in using defibrillator decreased, the accessibility of this basic life support increased. Any ambulance, even without the presence of advanced paramedics, is equipped by this device. Soon, police officers are also provided the use of AEDs. Being one of the first people to arrive at a medical emergency situation, police units can now give defibrillation to a patient. After continuous evidence that this device is extremely easy to utilize, public access to AED s are granted. These advances in the accessibility of AED dramatically increased the chances of survival of out-of-hospital cardiac arrests.
Nowadays, numerous states recognize the relatively easy-to-use function of AED in comparison to its importance. Due to this, there are true public access defibrillation programs on many states. The number of cardiac arrest occurrence remain to be staggering in amount. The presence of AEDs on any place may continue to increase just like how fire distinguisher is present in any establishment. Cardiac arrests can get just as deadly as fire, so why not have it readily available in your place?
Further explorations on human body has paved the way for more discoveries on administering cardiopulmonary resuscitation and all of them are put to practice to save more lives. In line with this, the American Heart Association (AHA) have listed some of CPR techniques that can be used aside from the conventional CPR approach in an out-of-hospital and in-hospital cardiac arrest scenario.
High-frequency compression is a technique practiced to improve resuscitations for a cardiac arrest. In this method, the compressions given on a victim must be at least 100 to 120 per minute. Clinical trials that have been conducted shows improved hemodynamics, that is the circulation of blood in the body, when high-frequency compressions are used compared to conventional chest compressions. It is important to note however, that there is still insufficient evidence to recommend daily use of this.
In an open-chest CPR, on the other hand, an incision is made into the chest (thoracotomy) to perform CPR directly against the sternum commonly known as the breastbone. This technique however, is highly recommended when a cardiac arrest happens during a surgery when the chest or abdomen of the patient is already open. Although in a very select scenario of out-of-hospital cardiac arrest in adults and children with penetrating trauma, this technique can be considered. Noteworthy to be considered, some cases where open-chest CPR and thoracotomy is performed, survivors have experienced minimal even zero neurological deficit.
Another CPR technique involves the simultaneous practice of abdominal compression, chest compression and ventilations. This technique is called the interposed abdominal compression (IAC-CPR). In this procedure, there will be three rescuers who would attend to a single cardiac arrest patient. The dedicated rescuer will provide manual abdominal compression during the relaxation phase of chest compression. The quality—hand position, depth, rhythm and rate—of abdominal compressions is the same as the one required for chest compression. This technique is commonly administered during an in-hospital cardiac arrest occurrence with satisfactory results of “improved coronary perfusion pressure and blood flow to other vital organs” in most reports. One limitation of this technique is that it still remains to be proven whether or not it should be done in an out-of-hospital setting.
Prone CPR, just like IAC-CPR, is a technique that is highly recommended for hospitalized patients where an advanced airway is easily accessible. The general knowledge in administering CPR is to move the patient to a supine position; however, there are isolated cases wherein a patient cannot be placed in such and is placed in a prone position instead.
There are also some cases when a cardiac arrest patient is awake and conscious so he can be “instructed” on using Cough CPR. As the name implies, a patient suffering from an anticipated cardiac arrest (an arrhythmic cardiac arrest under a catheterization laboratory) is coached to forcefully cough every 1 to 3 seconds. Now, it is important to note that this scenario is supervised and happens in a controlled environment and can only be done when a patient is responsive. Technically, it cannot be taught to lay rescuers.
All of these techniques have been recognized by AHA; however, there are still studies and tests that need to be done to test their effectiveness on increasing the survival rate of a cardiac arrest patient in both in-hospital and out-of-hospital setup. There is one general knowledge though, that still remains to be true and that is CPR saves lives. This fact is enough to encourage everyone to learn how to administer CPR properly and you can do so by undergoing training by Citywide CPR.
Cardiac arrest can literally occur at anyone, anytime and anywhere. Ironically, it can also attack people who are trying to keep their bodies in good shape both for aesthetic and health purposes. Gyms and fitness centers are just one of the many places where cardiac arrests are likely to occur.
Cardiac Arrests During Physical Activities
Cardiac arrest though unpredictable can stem out from many reasons. Reasons range from a family history of cardiac arrest, coronary artery disease, heart problems that are present at birth and many more. These tell-tale symptoms show itself through left-side chest pain, shortness of breath and even flu-like symptoms.
And yes, no one is exempted, even a fit sportsman. On October 24 of 1971, NFL player Charles “Chuck Hughes” died of a heart attack on the field during a game. Weeks before his death, he experienced chest pains and the doctors have failed to discover that he had already developed severe coronary atherosclerosis, an obstruction of the arteries due to plaque buildup. On top of that, he also had a family history of heart disease. His death, though a tragic blow, is something that we can all learn from.
A recent study by a team of renowned cardiac arrest investigators conducted on athletic participants with ages 35 to 65 have shown that some common physical activities can lead to cardiac arrest. These activities are jogging, playing basketball, cycling, gym activities, golfing, volleyball, tennis and soccer with 27% to 3% chances, respectively.
Gym activities have scored 11 percent possibility to incur cardiac arrest on middle-aged athletes. This may look like a small number, however, the statistics cannot be simply ignored. The study also highlighted that two-thirds of people who experienced cardiac arrests have experienced symptoms such as left-side chest pain and shortness of breath, a week before working out. In a recent survey for a study “Low Compliance With National Standards For Cardiovascular Emergency Preparedness At Health Clubs” 65 randomly chosen health or fitness centers in Ohio show 17% occurrence of cardiac arrest within a 5-year period.
Public Access Defibrillation In Fitness Centers
The numbers above show feasible data to support Public Access Defibrillation (PAD) programs on fitness centers and facilities. If cardiac arrest is likely to occur in one place, it is always better to have access to an AED in that specific area. In the chain of survival of cardiac arrest, early defibrillation must be administered to minimize damaging effects caused by the sudden halt of oxygenated blood flow to the brains and vital organs. Fitness facilities are just one of the many places where a cardiac arrest can occur, and pinpointing them will take lots of time. This is one reason why PAD programs must be furthered to save more lives.
A readily available AED placed in all health or fitness facilities, as permitted by law, only has one goal and that is to deliver successful defibrillation to a cardiac arrest patient. Along with the placement of this device, the importance of having proper training on how to use AED is also highly encouraged. Fitness facilities staff can have themselves enrolled in training for AED in institutions such as Citywide CPR.
Nobody wants to see someone’s life flash before their eyes, and even more when that someone is related to them. One of the vicious killers in the world comes with no dagger or gun, but it strikes fast with no more than a trace: cardiac arrest.
Cardiac Arrest: What Makes It Deadly
There are many cases wherein cardiac arrests happen outside the vicinity of a hospital, making it deadlier than it already is. Now, what really happens when a patient suffers from a sudden cardiac arrest? In defense of heart attack, cardiac arrest is a different issue. A cardiac arrest happens when the electrical impulses of the heart become erratic that makes the heart—a vital organ that supplies oxygenated blood to other organs such as the brain and lungs to keep them functioning—stop beating. There are times that a cardiac arrest can lead to heart attack that is when the blood supply to a heart muscle is obstructed. Nevertheless, a cardiac arrest is different from heart attack.
When there is no access to any person who knows cardio pulmonary resuscitation (CPR) or an Automated External Defibrillators (AED), the survival rate of the victim of cardiac arrest is significantly low. It is important to note that the flow of oxygenated blood needed by the brain has been halted, causing the deaths of numerous brain cells. The “death” of the brain cells can lead to serious damages to a victim even when he survives the arrest. The longer this supply is cut off, the slimmer the chances of survival are. This is one reason why everyone must know how to administer CPR.
High Frequency Chest Compression: Resuscitating A Cardiac Arrest Patient
As time changes, so does the advancement in techniques applied to save lives. Through more research and study, the used-to-be’s of CPR are now changed and altered to address the tiny details that have been overlooked in the past.
What started from a simple mouth to mouth resuscitation has now become one of the most vital first aid practices. In the past, the pattern ABC that stands for Airway, Breathing and Circulation is followed in administering CPR; however, further studies changed it to CAB. Furthermore, what was known as 1 ½ inches depth of compression are now improved to 2 inches. This to ensure that quality compression are administered to the victim while help is still on its way, and this is just the beginning.
Commonly referred to as high-frequency chest compression, a rate of 120 compression per minute must be done by a rescuer to improve resuscitation on cardiac arrest patients. This technique is given emphasis on the 2010 CPR Guidelines by American Heart Association (AHA). Along with the CAB approach, AHA encourages a simultaneous and choreographed approach to CPR in terms of chest compression as well. For every 30 compression’s, 2 breaths of air shall be given to the patient while administering CPR. This cycle is to be repeated over and over until professional help arrives.
Giving CPR can be tiring and exhausting; however, the frequency and duration of interruptions in compression must be kept at minimum. If there is another person who can give CPR, switch with them every once in a while. Then, after every two minutes of chest compression, check the ECG rhythm of the patient.
One of the most administered first aids is cardiopulmonary resuscitation, commonly referred to as CPR. As common as the said procedure might be, there are still some things that people seem to forget. This is why it is important that you know only the facts when it comes to CPR, and debunk myths and misconceptions.
Most people believe that only the older people and those that have medical conditions can receive CPR. There’s no solid basis this one since cardiac arrest can strike anyone at any time, no matter the medical condition or age.
It is also important that cardiac arrest and heart attack is differentiated properly with each other. Cardiac arrest is a sudden halt in the heart function that occurs when there is a disturbance in the electrical activity of the heart that makes it stop altogether, interrupting the blood flow to the brain. A heart attack, on the other hand, is caused by a blockage in blood flow to the heart muscle, and at times, can lead to cardiac arrest.
Although it is highly encouraged that CPR be done right away to increase the survival rate of a patient, it doesn’t always end up successful. In fact, the survival rate of out-of-hospital cardiac arrests is less than 10 percent. Nevertheless, CPR can significantly boost the survival rate by up to 30 percent if it is done right away and is immediately followed by electric shocks delivered by a defibrillator. This is also one reason why by-standers are highly encouraged to perform CPR while the ambulance is still on its way and this act can make a big difference.
It can be quite scary for someone who witnessed a patient be in cardiac arrest, much less perform a CPR when it can be very important. Unbeknownst to some, each by-stander who will do the CPR and cause unintentional injuries like breaking the ribs while administering the first aid are covered by the “Good Samaritan” laws, as it is commonly referred to as.
CPR goes beyond bringing a person back to life. In the occurrence of a cardiac arrest, victims will be cut off the supply of oxygenated blood travelling to the brain. Without these, brain cells can prematurely die and it can lead to irreversible neurologic damage. At times, even when a person survives the arrest he may experience lack of speech or immobilization. Good quality of CPR can reduce the risk of neurologic injury and minimize its extent.
One good thing about the richness of web is that anyone can have access to anything at any given time. Videos and modules that cover the basics of CPR are valuable resources that can reach countless people. No one knows when these instructional videos can come in handy. However, CPR certification requires an in-person training session.
Due to the importance of this first aid, CPR classes are offered widely and frequently, unlike the misconception that only a handful of places offer this training. If you are interested to upgrade your learning on CPR, aside from the usual videos that you can see on the internet, the American Heart Association and Red Cross websites list CPR training locations by geographic area.
Cardiopulmonary resuscitation, commonly referred to as CPR consists of chest compression and ventilation to maintain circulatory flow and oxygenation during a cardiac arrest. This is one of the most vital first aids and that’s reason enough to know how to do it. Also, anyone can have cardiac arrest no matter the health conditions, as a matter of fact, there is nothing to do to predict the occurrence of this. No one wants to be pessimistic about this but most likely the people you have to administer a CPR on will be someone in your circle.
How do you recognize a patient that needs to receive a CPR? If a person is suddenly rendered unconscious and does not have a pulse, a CPR must be administered quickly. If this incident occurs inside the hospital, they can provide a more detailed analysis on what type of cardiac arrest occurred including additional treatment options.
CPR, in entirety comprises chest compression, airway and breathing. Unlike what others believe in, delivering CPR on a mattress or other soft material is less effective. Instead, the patient has to be laid in a supine position on a hard surface while the one to give compression is positioned high enough above the patient to achieve sufficient leverage. Using one’s body weight can be very helpful in giving adequate compression on the chest. Once the patient is properly positioned, check the patient’s mouth for possible foreign object that can block the airway.
Next, the CPR provider must place the heel of one hand on the patient’s sternum and the other hand on top if the first with your fingers interlaced. Extend your elbows and lean directly over the patient then press down, compressing the chest up to at least 2 inches deep. It is important to note that administering CPR on younger age bracket can have different standards and requirements. Then, a compression rate of at least 100 per minute must be continuously done until the patient is transferred to definitive care. This can be physically exhausting on the part of the provider so if someone else is also present that can substitute every now and then, that is also encouraged to have the CPR continually administered until help arrives. For untrained bystanders, chest compression-only CPR (COCPR) should be performed while keeping in mind the general concept of “push hard and fast”. CPR can be given with or without breathing and if one is opting for no ventilation, this must be compromised with high quality compression.
Just like what is mentioned above, CPR for the younger age bracket has some differences compared to adult CPR. Instead of using the entirety of your hands, you should use two to three fingers in the center of the chest on the lower half of the breast bone to compress about 1 ½ inches deep. Breathing in air through mouth to mouth are still indicated by chest rise, but there must be enough caution and less air must be used to achieve the same normal breathing in an infant.
The general public must be knowledgeable on the importance of CPR and how to properly administer it, in or out of the hospital. This is why training are conducted and everyone is highly encouraged to attend them.
One of the causes of cardiac arrest, the leading cause of death in different parts of the world is a sudden disturbance in the heart rhythm called ventricular fibrillation. This occurrence cuts off blood supply to the brain and vital organs of the body causing them to fail. In some cases, it can lead to permanent brain damage or worse, death.
To treat this, an electric shock has to be applied to the chest of the patient through a process called defibrillation. In cases where a patient suffers cardiac arrest outside the premises of a hospital, Cardiopulmonary resuscitation, commonly known as CPR can be done to deliver a limited amount of blood and oxygen to the brain until defibrillation can be performed.
The Advent of Automated External Defibrillators
Back then manual defibrillation to cure cardiac arrest requires complex steps. The operator must know how to read and interpret heart rhythms and he must also know how to detect irregularities that require defibrillation. Lastly, he must know to operate a traditional model of defibrillator available at the time.
With the digitalization of defibrillators in the mid-1980s, Automated External Defibrillators, known as AED, a person’s heart rhythm can be interpreted without an operator. This is an advancement that allowed AEDs to be placed in ambulances that are not staffed with advanced paramedics.
The only issue to be addressed after that is how to get a victim to an AED within 10 minutes.
AED for Public Use
After the introduction of AED, police officers are then taught on how to operate the machine when the ambulance is yet on its way. It is now acknowledged that AED can be used by the general public. Of course, trainings on how to use this equipment is still encouraged, but AED can also be used even without one as long as local and state regulations are observed.
How To Use AED
There is only minimal input that a person has to do with performing defibrillation using AED. You have to press “on” and a computer-generated voice will guide you throughout the process. Next, you will be instructed to attach a set of adhesive electrode pads on the victim’s bare chest, in some cases, you must lug in the pads’ connector to the AED. On its own, the machine will read the person’s heart rhythm and will tell you if a shock is necessary. After this, it will automatically charge itself and will prompt you to press a button that will deliver the shock.
This current is the same current that will be delivered by a physician had the patient been in an emergency department or in an ambulance. Then, you will be instructed to resume CPR.
Although cardiac arrests mostly happen to adults, some cases such as the presence of commoto codios on children. This is a syndrome in which a blow to the chest during a specific time during the heart rhythm cycle can cause ventricular fibrillation.
If a child is the size of a typical eight-year old, then AED procedure on adults will be followed. On children older than one year of age but is comparatively smaller than an eight-year old, a special set of cables that can reduce the amount of energy to be delivered should be used.
The advances in technology provides innovations such as AED. Through this equipment, survival rates of cardiac arrest have begun to rise significantly. Along with the public access to this automated defibrillator, more and more lives are saved.