Dr Sunana Gupta
In today’s modern-paced world, unforeseen emergencies can strike unexpectedly, placing individuals in critical circumstances. The swift action of a person who is standing nearby the victim becomes paramount in determining the survival of those affected. The ability to provide basic life support(BLS) skills becomes a crucial aspect in such scenarios, empowering bystanders to take immediate and life-saving measures. This article highlights the importance of raising awareness and facilitating access to BLS training, as it has the potential to significantly enhance bystander Cardiopulmonary Resuscitation and contribute to a safer community. What is basic life support (BLS) ? Basic Life Support (BLS) refers to a set of essential medical techniques and actions that are provided to sustain or support life during emergencies, particularly in situations where a person’s breathing or heartbeat has stopped.
BLS aims to maintain blood circulation, ensure adequate oxygenation, and support vital organs until professional medical assistance arrives. In what situation do you apply the basic life support? Cardiac arrest is a sudden loss of blood flow throughout the body resulting from the failure of the heart to pump effectively. Absence of blood flow results in lack of oxygen being provided to the brain, which leads to loss of consciousness and abnormal or absent breathing. Brain injury is likely to happen if cardiac arrest goes untreated for 4-6 minutes. For the best chance of survival and neurological recovery, immediate resuscitation (BLS) is required. Other situations where basic life skills are required are Choking, Drowning, and the person who is not breathing. What is out of hospital cardiac arrest? Out-of-hospital cardiac arrest (OHCA) is the loss of functional cardiac mechanical activity in association with an absence of systemic circulation, occurring at a setting outside of the hospital. OHCA is a common, time-critical disease and is a major cause of mortality and morbidity globally. Despite advances in healthcare, mortality in OHCA remains high. In the Indian subcontinent, the most common cause of cardiac arrest is cardiovascular disease accounting for almost 60-65% of cases, and appropriately executed bystander CPR can drastically increase survival rates in these patients Every second that mattersin cardiac arrest Time isimportant during cardiac emergencies as with each passing second without CPR the chances of survival of the victim also diminish. Studies have shown that performing CPR within the first few minutes of a cardiac arrest can double or even triple the likelihood of survival. The presence of a trained bystander who can initiateCPR before the trained help is available makes a lot of difference. With most cardiac arrests occurring outside of hospitals, the onus is on the community to take immediate action and be the lifeline for their fellow citizens. What is Bystander Cardiopulmonary Resuscitation ( CPR)? Bystander CPR refers to the immediate administration of life-saving skills by a person, often a bystander or a layperson, to a victim experiencing a sudden cardiac arrest. In India Bystander CPR rate has been found to be 1.3%.This is very poor in comparison to the bystander CPR rate of 18% -55% reported from the West. For India, the availability of a larger number of CPR-trained laypersons is the need of the hour, as medical help may take time to reach the site of cardiopulmonary arrest. Barriersto low CPR rates in India 1)One of the main reasons for low rates of bystander CPR in our country is the lack of awareness and training in basic CPR techniques at the community level. Improving community bystander CPR rates is an important step toward improving OHCA survival. The awareness of cardiopulmonary resuscitation in the Indian population is less than 2%. So, there is a need to increase the knowledge in the community about CPR by having widespread awareness and training programs throughout the country. 2)Bystanders may be hesitant to intervene during an emergency due to fear of doing harm because of a lack of confidence in BLS skills. Concerns about potential legal implications can also deter people from performing CPR. 3)Limited access to resources can hinder the dissemination of life-saving information and training programs, making it challenging for communities to build awareness and skills related to CPR. 4) The lack of accessible healthcare facilities in remote areas can reduce the likelihood of bystander CPR being initiated, as immediate professional help may not be readily available. Overcoming the barriers 1) Creating awareness. In today’s digital age, technology and media can play a pivotal role in spreading awareness.Media platforms offer diverse ways to reach a wide audience and inspire individuals to take the first step towards learning BLS skills. By collaborating with the media, we can ensure that the importance of BLS training receives the attention it deserves. 2 )Accessible and Affordable BLS Training Providing accessible and affordable Basic Life Support (BLS) training is essential to empower as many individuals as possible with life-saving skills. By urging schools, workplaces, and community organizations to prioritize CPR training, we can cultivate a generation of individuals who understand the significance of their actions during emergencies. Organizations, schools, and communities can collaborate with healthcare professionals to offer basic life support training at affordable cost . 3 )Laws Protecting Bystanders: The Good Samaritan Law It is essential for individuals to be aware of the legal protection provided to bystanders who attempt CPR in good faith. The Good Samaritan Law shields individuals from liability when providing reasonable assistance during emergencies. Knowing that they can help without fear of legal repercussions can encourage more people to become proactive life-savers. 4 )Providing BLS training to schoolchildren One of the ways to improve bystander CPR rates is to train school children, which will increase the percentage of the population trained in the community. CPR anytime programme of the American Heart Association (AHA) trains middle and high school students regarding the knowledge and performance of Hands-Only component of CPR (HOCPR). In 2015 WHO endorsed the “Kids Save Lives” statement of training school children in CPR worldwide. Benefit of training school children is that through them we can reach all groups of society and school children have a less inhibited approach to resuscitation training. Further, a sense of responsibility can be firmly established at an early point. The national council of educational research and Training (NCERT) has also included CPR in the Class IX curriculum. 5)Training traffic, fire, police personnel, and drivers Training these targeted groups in the society can have a significantimpact in emergency situations as they are often the first ones to arrive at the scene of any medical emergency. If they are trained in basic life support techniques, they can provide immediate assistance before medical professionals arrive, increasing the chances of survival of the victim. 6)Government Support Support from the government is essential to ensure the successful implementation and sustainability of these awareness and training programs. Implementing BLS and CPR training programs requires financial resources for training materials, equipment, and instructor training. Governments can allocate funds to support community-based training initiatives, making them accessible to a broader range of individuals and organizations. 7) Integration in Occupational Health and Safety: Encouraging organizations to include basic life support training as part of their occupational health and safety programs. Department of Anaesthesiology,AIIMS Jammu, has initiated awareness campaigns focused on teaching Basic life skills in community targeting school children, traffic personals and drivers. These campaigns are already underway and will be ongoing in the future. By investing in BLS training and promoting public awareness, we can create a safer society where individuals are prepared to respond effectively in emergencies. (The writer is Additional Professor, Anaesthesiology and Critical Care, AIIMS Jammu).