Under the leadership of the heart project, “The Symposium of Sudden Cardiac Arrest Survival” was conducted with the cooperation of both Hayatta Kal Dernegi (Stay Alive Association) and İstanbul AREL University to find approaches to increase the survival rate of out-of-hospital sudden cardiac arrest (SCA), which is unfortunately less than 1% in Turkey.
The symposium was conducted by Bilgin Timuralp, who is the chief editor of Anatolian Journal of Cardiology, and Gülay Yedekçi, who is the vice president of Hayatta Kal Dernegi. Mutlu Vural and Pervin Tunç both were directors and lecturers in the symposium.
Başar Cander, who is the president of Association of Emergency Physicians, stated that online hands-only cardiopulmonary resuscitation (CPR) or basic life support courses should also be certificated in Turkey. These first aid courses are widely used for mass society education in many countries. He reported that SCA is an important public health problem today and is the leading cause of death in many countries, despite progress toward first aid and medical interventions. In the United States and Canada, approximately 350,000 people annually develop SCAs, and 50% of them undergo CPR. The rate of performing CPR in out-of-hospital SCAs is respectively 1.7% in Turkey. Basic life support training to all potential first aiders encourages them to perform CPR immediately, because any delay greatly reduces the chance of maintaining life. Basic life support skills “practice while watching” (video-based) is not very long in the form of training. You can learn equally with traditional instructor-led courses. Interventions to SCAs should also be performed after an online training. After a 1-h training, the basic life support online certificate should be given to the test-takers. Thanks to this, public awareness should be increased, and each event on-site facility can be found in the individuals who can interfere with a SCA. Moreover, successful results for survival rates have already been obtained in developed countries where online first aid education was applied.
Mehmet Birhan Yilmaz, who is a professor of cardiology in Cumhuriyet University, gave a lecture entitled “First Aid: Is Breathing Really Necessary?” What is chest compression-only CPR? It is a relatively novel method of CPR characterized by continuous forceful chest compressions to circulate the person’s blood to their brain and heart, without accompanying rescue breathing for adult cardiac arrest patients. It is well established that interruption of chest compressions for more than 5 s, as in the case of usual traditional CPR, results in a pause in the blood flow to the brain (Evy GA et al. Circulation 2007). Hence, in the first minutes of cardiac arrest, particularly in case of an untrained individual, it might be particularly much better than doing nothing. Furthermore, chest compression-only CPR overcomes the problem of hesitation of mouth-to-mouth breathing due to several reasons. Therefore, chest compression at a rate of 100 bpm and at a force generation of 5-cm depth will bring life to the victim.
Nevzat Alkan, who is a professor of forensic medicine in Istanbul University, explained “Legal Responsibility In First Aid For SCA.” There have been specific regulations made in the legal system focusing on first aid for SCAs in our country as well as many countries of the world. First aid for SCAs is evaluated in a medical emergency coverage. SCAs are a major cause of unexpected death. Therefore, the entire community should follow a systematic and dynamic approach to first aid in a conscious manner in order to eliminate worse outcomes for these types of emergency situations.
In our country, forensic medicine is referenced in the evaluation of medical malpractice claims. Therefore, forensic medicine approaches play an important role in the evaluation of legal responsibility that may arise during effective and dynamic first aid efforts for SCAs. In general, forensic medicine exhibits a more positive approach to first aid interventions in medical malpractice assessment compared with other branches. The main factor for this approach is the environment where the emergency response process is performed, which is generally chaotic and tense. The approach of forensic medicine is a very positive assessment of the problems arising during the intervention for SCAs. Because first aid is performed in emergency conditions, during which each second is important.
Consequently, our all people should be informed, trained, authorized, and encouraged in response to SCAs. Thus, when and where cardiac arrest will take place is uncertain; but with first aid for SCAs, the chances of survival of loved ones will be even higher.
Pervin Tunç gave a lectured entitled “How To Perform Massive First Aid Education In The Population.” First Aid is in the scope of fundamental rights of life, and education is an important part of human rights. First aid should be identified for target groups. First aid training must be given to the following people:
Teachers
Press members
Police officers
All managers
Drivers (driving courses, insufficient)
Workers and foremen
Army (during military service)
Tourism professionals
Apprenticeship training areas
Civil defense and fire fighters
Religion officials
Babysitters or nannies
Public and Municipal employees
To raise awareness as well as first aid, İstanbul Arel University and Stay Alive Association have come together to understand the importance of this issue in the young generation. Examples in the sense of social responsibility have created a model showing positive attitude.
Mutlu Vural, who is the president of Hayatta Kal Dernegi (Stay Alive Association), defined hands-only CPR and lifesaving chain.
After showing the Turkish dubbing of “Official 2012 Hands-Only CPR Instructional Video” with copyright from American Heart Association, Vural said that it costs 4 billion US dollars for adults to obtain 16 h of advanced first aid certification, which is unfortunately a commercial monopoly in our country. Hands-only CPR is cheap and suitable for all people to save many lives of an annual 100,000 SCA victims. Nurse students performed a lifesaving chain ritual, which had “Award of Best Activity of The Year” in 2014, with the help of 103 rpm rhythm of the “Hayatta Kal” song.
In conclusion, all lecturers declared that the anxiety of performing chest compressions to a beating heart is exaggerated in our society. They declared that breathing is unnecessary during first aid efforts in SCAs in teenagers and adults. First aid certification is important to avoid legal responsibility in case of an unsuccessful first aid in SCA victims. Online hands-only CPR or basic life support courses are suitable for mass society first aid education. In this way, survival rates from SCAs will increase in our country, which is actually only about 1:20 of that in developed countries.