Cardiac Arrest Treatment Options

The world today mourns the death of Joan Rivers, a pioneering American actor, comedian, writer, producer, and television host. She died on September 4, 2014 following serious complications including cardiac arrest during a procedure on her vocal cords at a clinic on the Upper East Side of Manhattan. 

Rivers, 81, had been on life support at Manhattan's Mount Sinai Hospital, where she was taken after she stopped breathing at the Yorkville Endoscopy clinic last Thursday. Rivers was undergoing an apparently minor elective procedure at the clinic when she suffered cardiac and respiratory arrest. Paramedics took her by ambulance to Mount Sinai Hospital, about a mile from the clinic, where she was initially listed in critical condition.

Things you need to know about cardiac arrest:

What is a cardiac arrest? In simple terms, it means that the heart has stopped beating. The heart gets arrested at a point where it no longer beats, and the blood circulation to all parts of the body stops. If cardiac arrest is left untreated, it can result in death.

What happens in cardiac arrest? The heart stops its pumping action, blood stops flowing to all the organs, most importantly to the vital organs like brain,resulting in global ischemia. At the cellular level, various biochemical reactions occur resulting in cellular swelling and damage.

Caring for a patient with cardiac arrest?

1: Call 911 or emergency healthcare numbers in your area or the nearest hospital ambulance (keep this number handy, stick near your land phone or store in your handset). Every millisecond counts in cardiac arrest hence the importance of keeping the numbers handy. Each millisecond delay cannot bring back the dying heart muscle fibre.

2: Perform CPR – cardio-pulmonary resuscitation. Once you call for ambulance, CPR is the next step. It comes handy for every adult to learn the technique of CPR. When properly executed, it can save several lives. The main objective of this method is to restart the heart beat and to push air into the lungs.

How to perform CPR: Put one hand on the center of the person’s chest. Put your other hand on top of it. Press down firmly, using your weight if necessary, to push the chest inward. Relax only long enough to let the chest spring back, and do it again. Keep repeating the press-relax cycle about twice a second (the ideal is 100 per minute). Don’t worry about doing it wrong — poorly performed CPR is better than none at all. You can continue this till the ambulance arrives.

3: Rush the patient to the medical facility - As you perform the CPR, rush the patient to the nearest medical facility. Check for airway and breathing. If oxygen is available, give it to the patient.

What is done at the medical care facility? - Doctors usually assess the vitals of the patient and check the consciousness status. Most of the times, CPR is routinely done on an unconscious patient. Once the cause of the cardiac arrest is confirmed, all attempts would be made to treat the primary underlying cause.

Post - resuscitation care: Securing IV access, monitoring oxygen supply and electrical activity of the heart, maintaining the vitals, continuous ventilation and life support would be ongoing.