[Health Tip] The 'Golden Time' 4 Minutes... CPR and AED to Save Cardiac Arrest Patients

Philips' Automated External Defibrillator (AED) 'HeartStart FRx'

[Asia Economy Reporter Chunhee Lee] When someone suddenly collapses due to cardiac arrest, emergency measures must be taken quickly. Generally, if emergency measures are not performed within 4 minutes, oxygen supply to the brain is cut off, leading to severe brain damage or death. Performing cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) within the "golden time" of 4 minutes can increase the survival rate up to 80%, but if emergency measures are delayed, the patient's survival probability decreases by 7-10% for every 1-minute delay.

Accordingly, education on emergency treatment such as CPR and AED usage is included in basic education, but it has been found that few people properly master it. According to the "Nationwide High School Emergency Treatment Education Status" announced by the Korea Consumer Agency in May, a survey of university students who had received emergency treatment education during high school showed that only 1 in 10 knew the emergency treatment procedures and methods accurately. The percentage of those who only knew the order of emergency treatment was 56.4%, and the percentage who were familiar with AED usage was 24.5%. Although the implementation rate of emergency treatment education in high schools nationwide exceeds 90%, it is rare for people to know the correct treatment methods when facing a cardiac arrest patient. Despite more than 30,000 cardiac arrest patients annually in Korea, the rate of laypeople performing CPR when witnessing cardiac arrest was only 26.4% in 2020, which is not unrelated to this situation.

Especially this summer, as strong heatwaves continue worldwide, the need to be well aware of such emergency treatment guidelines is increasing. According to a study by Professor Oh Se-il of the Department of Cardiology at Seoul National University Hospital and Professor Kang Si-hyeok of the Department of Cardiology at Bundang Seoul National University Hospital, analyzing 50,318 acute cardiac arrest patients from 2006 to 2013 in six metropolitan cities including Seoul, the incidence of acute cardiac arrest increased by 1.3% for every 1-degree rise in summer temperature.

The recently revised 2020 Korean CPR guidelines provide a very simple CPR procedure. ① When discovering a cardiac arrest patient, call 119 and ask people nearby to bring an AED. ② Chest compressions should be performed with strong force to a depth of 4 cm for infants (0?1 year), 4?5 cm for children (2?7 years), and about 5 cm (up to 6 cm) for adults (8 years and older). The rate should be 100?120 compressions per minute, and interruptions should not exceed 10 seconds. ③ When the AED is ready, follow the voice prompts. Repeat CPR and defibrillation until the 119 rescue team arrives or the patient regains consciousness.

In the CPR guidelines, the AED used alongside chest compressions is an emergency medical device that automatically analyzes the heart rhythm of cardiac arrest patients and can be used by laypeople to assist resuscitation. The AED operates in the following order. First, remove the patient’s upper clothing and attach the pads to the patient’s chest according to the pictures and voice prompts on the device. Second, the AED analyzes the patient’s electrocardiogram and, if a shock is needed, automatically charges the energy for defibrillation after a voice prompt. During this time, called the "hands-off time," CPR must be stopped and you must stay away from the patient. The longer this time lasts, the lower the patient’s chances of survival and recovery, so the American Heart Association (AHA) recommends keeping hands-off time within 10 seconds. Third, when the voice prompt instructs to deliver a shock after the hands-off time, press the orange button to administer the shock. Immediately resume chest compressions afterward. Even if the device determines that a shock is not necessary, continue chest compressions. The AED analyzes the patient’s electrocardiogram every 2 minutes and advises on the need for defibrillation.