Less than 2% of population in India trained in CPR as against requirement of 30%

Stressful routine, unhealthy eating habits and lack of physical exercises are not only reducing the life quality of a person, but also making them prone to heart diseases at a young age. On International Cardiopulmonary resuscitation (CPR) Day, observed on July 27, Bizz Buzz spoke with Dr Rakesh Garg, Scientific Director, Indian Resuscitation Council, on the importance of CRP training amongst general public, a skill which can increase the survival chances up to 40 percent in a patient experiencing sudden cardiac arrest

Two to three decades ago, cardiac diseases were seen more in the age group between 50 years to 60 years. In the past one decade, we are seeing rise in cardiac diseases amongst youngsters between the age group of 20 years to 25 years. This is a worrisome situation. Male are more prone to cardiac issues due to change in hormones whereas women, post menopause age, are susceptible to heart diseases

CPR awareness activities have been happening in India for a very long time, but mostly amongst small batches of people. There was no uniformity on this. So, to increase awareness gradually, days such as World Restarter Heart Day, observed on October 16, was introduced. Similarly, CPR Day was started three years ago with a basic purpose that this one day can be observed for its mass awareness. But CRP training is provided throughout the year

When is it required to perform a Cardiopulmonary resuscitation (CPR)?

So, you must have heard of situations when a person is taking a walk in the park or at home suddenly collapses and when taken to the hospital the patient was dead. These are the events which are common scene and this type of sudden cardiac death majority will happen outside the hospital. These are primarily in adults due to heart issues. Once the heart stops working, the chances of survival drop five to seven percent every minute.

In such situation, across the worldwide, if such a scenario takes places, it takes 10 to 15 minutes to take a patient to the hospital. CPR is basic skill that manually keeps the heart beating and thus buying some time for the doctors to do something.

80 percent of sudden cardiac arrests happen outside hospitals. Here, we intent to include the layman person since they will be closest to the patient in that moment. Our intent is that every layman should learn this life saving medical emergency.

When did CPR Day begin in India?

CPR awareness activities have been happening in India for a very long time, but mostly amongst small batches of people. There was no uniformity on this. So, to increase awareness gradually, days such as World Restarter Heart Day, observed on October 16, was introduced. Similarly, CPR Day was started three years ago with a basic purpose that this one day can be observed for its mass awareness. But CRP training is provided throughout the year.

CPR training are often provided to healthcare professionals and armed forces personnel such as CISF, Police. So, how can these training activities be taken forward to the general public?

Indian Resuscitation Council (IRC) has issued three different guidelines on CPR. One is Comprehensive Cardiopulmonary Life Support which is taught to doctors and other healthcare workers in the hospitals. Second is Basic Cardiopulmonary Life Support which is given to trained personnel who are outside the hospitals.

Third is Compression Only Life Support given to the layman. These three techniques are present at different levels to deal with cardiac arrest inside and outside the hospitals. But resuscitation resources which are available in the hospitals may not be available outside, but CPR techniques should be available for situations where medical assistance might not be present then and there.

We have various studies which indicate that mere chest compression can save 20 to 40 percent of such patients who experience sudden cardiac arrest. There are countries like Sweden that has 100 percent CPR training of adults.

In India, what is the percentage of general population which is trained in CPR?

According to a government data published in 2013, less than two percent of the population in India is trained in CPR. At IRC, we want that one person in every family should be trained in CPR. So, we have to train at least 20 to 30 percent of such population. We do not have a robust data, but outside a hospital, if a person has cardiac arrest, the provision of CPR is less than one percent.

When it comes to sudden cardiac arrest, which age group and gender is more susceptible to heart failure?

Heart diseases, on a broad parameter, can be attributed to stressful lifestyle which is common in metro cities. Lifestyle modification is too much now.

Another reason maybe because of changing eating habits where we prefer more of junk foods, reheated food instead of natural food. Thirdly, if you see, India is becoming a diabetic hub. Diabetic condition, if left untreated, is known to cause cardiac disease. We should not ignore our symptoms else the disease might progress.

Two to three decades ago, cardiac diseases were seen more in the age group between 50 years to 60 years. In the past one decade, we are seeing rise in cardiac diseases amongst youngsters between the age group of 20 years to 25 years. This is a worrisome situation. Male are more prone to cardiac issues due to change in hormones whereas women, post-menopause age, are susceptible to heart diseases.

What is the importance of conducting CRP trainings at educational institutional level?

Recently, Central Board of Secondary Education (CBSE) has incorporated this resuscitation program for school students. So, we can say that these school students are our ambassador because they will be with us in the community for the next 9 to 10 decades. If we say that the CPR training can be given to age group above 12 years, I think we can generate a pool of generation who will be well versed on this emergency critical service. This is the most mature decision to train young students.

As of 2021, during the ongoing Covid-19 pandemic, what is the importance of CPR?

Many Covid-19 infected patients have died who were given CPR. Outside the hospitals too similar situations were there. For CRP training, we are creating awareness, imparting knowledge and demonstrating skills to perform the activity. We use mannequin dummies to train people in CPR. We have to follow safety protocols during these times and cannot conduct CRP training in groups. This may further lead to spread of Covid-19. So, virtually, we are focusing on CRP awareness so that when the norms are relaxed, we may conduct CRP skill training to masses in person. We can train a person to perform basic CRP in 30 minutes.

What are some of the dos and don'ts while performing CPR?

CPR is not performed on live, conscious people. Also, mouth-to-mouth should not be given by layman while giving CPR.

We have enough evidence to support that mouth-to-mouth breathing is very highly technical skill, it cannot be taught in a day. This technique requires consistent practice and repeated efforts. As of 2015, the guidelines on CRP were revised and it is no longer advisable for a lay man to do mouth-to-mouth breathing on a patient while performing Compression Only Life Support.