The much-needed nationwide launch of Cardiopulmonary resuscitation (CPR) — a lifesaving technique that is useful at times when someone’s breathing or heartbeat has stopped— by the Government has been triggered by a spate of deaths due to cardiac arrest in the last few months. On average every minute, over 100 persons are getting cardiac arrest in the country. The majority of them can be saved if given timely CPR. ARCHANA JYOTI reports
Kick-starting the country-wise CPR campaign in which more than 20 lakh people participated on December 6, 2023, Dr Mansukh Mandaviya, Union Health Minister said that “Patient must be administered treatment immediately on suffering a cardiac arrest hence awareness and adequate training for CPR is paramount.”
Dr Abhijat Sheth from the National Board of Examinations which has been roped to train people across the country on giving CPR added, “There has been an increase in the number of cases of sudden deaths, and knowing CPR can save a lot of these lives till the ambulance arrives or the person reaches the hospital.”
However, health experts felt that public awareness campaigns and ongoing training programs should become a regular and integral part of public health initiatives rather than a one-time event to equip the public with the knowledge and skills necessary to perform CPR when the need arises.
"This initiative could involve collaboration with educational institutions, workplaces, and community organizations to reach a broad audience,” they said.
"Widely accessible CPR training ensures that individuals can confidently administer aid, transforming ordinary citizens into potential lifesavers. In essence, the 150 seconds it takes to read this highlights the time-sensitivity of CPR, underlining its pivotal role in the chain of survival and its enduring importance in emergency medical care, said Dr Imtiyaz Gani Reshi, Head of Emergency Medicine and Trauma Services Department, Fortis Hospital, Greater Noida.
He described CPR as a crucial intervention to maintain oxygen delivery to vital organs, acting as a stopgap measure until professional medical help arrives.
CPR's impact extends beyond mere survival; it minimizes the risk of long-term complications by preserving organ function during the critical moments following cardiac arrest, said Dr Reshi.
Additionally, health experts have also sought to ensure access to automated external defibrillators (AEDs) in public spaces that can further enhance the effectiveness of CPR interventions. A coordinated effort involving healthcare professionals, first responders, and the general public can create a network of support that significantly improves the chances of survival in cardiac arrest cases, they said.
Different findings from a study, published recently in Frontiers in Nutrition and Nutrients, have shown that consuming foods high in fat before a mentally stressful episode can reduce brain oxygenation and cause poorer vascular function in adults. Dr KK Talwar, Chairman, PSRI Heart Institute, Delhi said that, in case of emergency, if one is unsure about giving correctly or how to give it, it must be noted that it’s always better to try than do nothing which on many occasions could be the difference between life and death. Once this training is imparted it is seen that the number of people ready to impart CPR increases manyfold, and this readiness, when put to practical use ends up saving many lives, added Dr Talwar..
In fact in an event in 2019, Venkaiah Naidu, the then Vice President gave a clarion call that everybody should be trained in CPR.
He also exhorted the organized sector to impart CPR training to their employees as he pointed out that in Western countries the students of High Schools are trained in the life-saving technique.
Naidu also insisted on the pressing need to bring out legislation to make CPR mandatory in school education. However, in India, just two percent are aware of how to do CPR
“CPR is an issue in India because we have never trained the public. We do not have a robust emergency medical system and ambulances can’t reach in the first three minutes, when CPR can be life-saving. Remember former President APJ Abdul Kalam who suddenly collapsed at a function. But nobody could do the CPR,” Dr SSC Chakra Rao, chairperson of, Indian Resuscitation Council (IRC) echoed Naidu’s views.
“If we talk about data then almost 80 to 82 per cent of cardiac arrest happens outside the hospital. With each minute the chances of survival decrease by 7 to 10 minutes,” added Dr Rakesh Garg, Additional Professor of anesthesiology, intensive care, and palliative medicine at AIIMS, Delhi, and scientific director, of Indian Resuscitation Council.
“If we don’t immediately give CPR, the patient will have a brain injury. In some countries, with increasing practice of CPR, it has been found that 40-60 per cent of people could be saved. Since time is important, any layman can manually start a heart with a skill which can be learned with a practice of 5-10 minutes and can save a life,” The IRC has also formulated the CPR guidelines for the laypersons known as COLS--Compression Only Life Support.
This simplified form of CPR is recommended for individuals who are not trained in conventional CPR with rescue breaths or for situations where the rescuer is uncomfortable giving mouth-to-mouth ventilation. Besides CPR, it’s also important to know how to use an AED.
“You just turn it on and the device tells you exactly what to do, which is placing pads onto the person’s chest,” said Delhi-based cardiologist Dr PK Rana. “The device will identify whether the rhythm the patient has is one where an electrical shock can actually revive them or make them responsive again. And if that’s indeed the case, all you have to do is press a specific button on the device to do so.”
However, though Delhi Metro has installed these devices at some of its stations, very few passengers are aware of their existence and importance. These were installed only after the DMRC got a nudge from the Delhi High Court following a petition by the late eminent cardiologist Dr KK Aggarwal, who had been raising the need for CPR training at various platforms.
The Kochi Metro has decided to be cardio-emergency responsive with the installation of Automated External Defibrillator (AED) machines at all of its stations.
The AED requires minimal training for operating and is essential in improving outcomes from sudden cardiac arrests. They should be available in most places where large public gatherings occur.”
However, in India, much needs to be done.
A study published in a recent edition of the Indian Heart Journal, says that “India lacks a formal sudden cardiac arrest (SCA) registry and the infrastructure for a robust emergency medical services (EMS) response system.”
The study ‘Outcomes of out of hospital sudden cardiac arrest in India: A review and proposed reforms’ also underlines that “tireless efforts for bystander CPR training at different levels of communities, institutions and throughout the nation will help build a nation of lifesavers.”
The authors of the study included cardiologists Dr Rakesh Yadav and Dr Nitish Naik from the Department of Cardiology, Cardiothoracic Center, AIIMS, Delhi among others.
The writer is Associate Editor, The Pioneer
