I am working in the Emergency Department when we receive a call over the radio.
"Inbound lights and sirens with a Latina female in her 50's, non-responsive, in cardiac arrest!"
I brace myself for an all-too-common occurrence.
As the woman is wheeled into the room, paramedics are performing lifesaving CPR to try to restart her heart. Twenty minutes later, as the attending Emergency Department physician, I call out her time of death.
As I make my way over to her family, many questions are running through my head. Did the family notice when their mother started to feel dizzy, nauseous and had chest pain? Did they know to call 9-1-1 immediately when she collapsed? When the dispatchers told them to perform CPR on their mother, did they know what to do?
Every hour in the United States, about 50 people will have a sudden cardiac arrest outside of the hospital.1* A cardiac arrest is when the heart stops and can no longer pump blood to the brain and other vital organs in the body. Only one in 10 people survive a cardiac arrest. Yet, a simple lifesaving skill, CPR, can triple a person's chance of surviving a cardiac arrest. CPR works by pumping blood to the brain and other vital organs when a person's heart has stopped.
Unfortunately, there are striking health inequities in who receives CPR and who survives a cardiac arrest. 2* In the United States, Latinos are 30 percent less likely to have someone perform CPR when they suffer a cardiac arrest. People who live in lower-income neighborhoods are an additional 51 percent less likely to have CPR performed. 3* Because cardiac arrest survival depends on the actions of others (e.g., calling 9-1-1, performing CPR), where you "drop" can dramatically affect your chance of surviving a cardiac arrest.
I approach the family and begin to ask questions. Their mother had not mentioned the symptoms she was having until just before she collapsed, even though her chest pain had started the night before. They tried to wake her up, but waited critical minutes to call 9-1-1 because they had concerns. Could they afford the cost of an ambulance and a hospital stay? Would the police come and, if so, what would happen to their cousin who was undocumented? Would they all be in trouble? Ultimately, because they did not know CPR, they didn't perform it and waited until paramedics arrived an agonizing eight minutes later. (For every one minute that CPR is not started, a cardiac arrest victim's likelihood of surviving decreases by 10 percent.)
As an emergency medicine physician, I am tired of caring for cardiac arrest victims, of any race, age, demographic, who delay seeking medical care, who do not receive CPR and who do not survive. Without proper education, the health inequalities among Latinos will continue. But that does not have to be the case. Everyone deserves a chance to live and every person should know CPR. It can save a life.
The American Heart Association is working to educate Latinos so they know what to do when someone they love suffers a cardiac arrest. There are two simple steps to performing bystander CPR: (1) Call 9-1-1 and (2) push hard and fast in the center of the chest (at about 100 times a minute).
During National CPR Week June 1-7, please send the following websites to your family and friends:
• The American Heart Association has a website specifically for Spanish speakers at www.heart.org/rcp. On the website, people can learn, in less than two minutes, how to perform Hands-Only CPR™.
• English-speaking audiences can visit www.heart.org/handsonlycpr for more information.
The only way that we will end the health inequities we see every day in our emergency departments is with your help. Encourage everyone you know to learn CPR.
1*. Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics--2014 update: a report from the american heart association. Circulation 2014;129:e28-e292.
2*. Sasson C, Meischke H, Abella BS, et al. Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for healthcare providers, policymakers, public health departments, and community leaders. Circulation 2013;127:1342-50.
3*. Sasson C, Magid DJ, Chan P, et al. Association of neighborhood characteristics with bystander-initiated CPR. N Engl J Med 2012;367:1607-15.