Cardiac Arrest Treatment

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A cardiac arrest is fatal unless treatment begins immediately. Most cardiac arrests occur outside of hospitals. This means that emergency care of the affected person depends on family, friends, or people in the community.

It is important for everyone to know the symptoms of a cardiac arrest and to act if they see someone having one. Important steps include calling 9-1-1 first, performing CPR, and using an automated external defibrillator (AED). If no one else is around — for example, if a cardiac arrest occurs at home — a family member or caregiver can call 9-1-1 while performing CPR.

AEDs are special defibrillators that untrained bystanders can use. They are often available in public places like airports, office buildings, gyms, and shopping centers. AEDs give an electric shock if they detect a dangerous arrhythmia, such as ventricular fibrillation. The devices “talk” to the user to give step-by-step instructions.

AEDs are not hard to use, but training is very helpful. AED training is often done along with CPR training. Many major health organizations offer classes. Some training is available online. Find a course near you.

Steps to help a person having a cardiac arrest are listed below.

• If you see someone collapse, check to see whether the person responds to shouting and tapping on their body. Check for breathing and a pulse. If the person is not breathing normally and if they do not respond, call 9-1-1 for help.
• Start CPR.
• Locate an AED. Follow the AED’s verbal instructions to deliver a shock to restart the heart of the affected person.
• Naloxone should be given as part of emergency treatment for cardiac arrest possibly caused by opioid overdose. First responders carry naloxone. If the person is known to be at risk of opioid overdose and you are trained to give naloxone, you can treat them before first responders arrive.
• Continue CPR until first responders arrive and take over. First responders will continue CPR and may use an AED to give more shocks to restore the affected person’s heart rhythm. They may also give medicines through an intravenous (IV) line.

If you survive a cardiac arrest, you will be admitted to a hospital for ongoing care and treatment. In the hospital, healthcare providers closely monitor your heart. Hospital treatment focuses on preventing organ damage, especially to the brain.

• Targeted temperature management (TTM) is necessary for all patients who cannot follow commands after their heartbeat returns. TTM helps protect the brain by lowering the body temperature using cooling blankets, cooling helmets, ice packs, or other methods.
• Oxygen therapy can help get enough oxygen into your lungs so your organs can keep functioning as you recover.
• Extracorporeal membrane oxygenation (ECMO) treatment pumps blood through an artificial lung to add oxygen and remove carbon dioxide before returning the blood to your body. Read more about our study showing that ECMO life support may improve survival of patients who have an out-of-hospital cardiac arrest and do not respond to standard life support.

While you are in the hospital, your medical team will try to find out what caused your cardiac arrest. If you are diagnosed with coronary heart disease, treatments may include medicines and surgical heart procedures such as bypass surgery and percutaneous coronary intervention (also known as coronary angioplasty ), a procedure that may also include placing a stent. These procedures help restore blood flow through narrowed or blocked coronary arteries.

Having one cardiac arrest means you are at risk for another one. Cardioverter devices are defibrillators that your doctor can implant in your body or that you can wear to help keep you safe. The devices can detect serious rhythm problems and use electric pulses or shocks to help control dangerous arrhythmias. Your healthcare provider may recommend one of the devices below.

• An implantable cardioverter defibrillator (ICD) is surgically placed under the skin in your chest or abdomen. It has a battery and connects to your heart with wires called leads. If the ICD detects a dangerous arrhythmia, it can act as a pacemaker or give your heart an electric shock to restore a normal rhythm. Risks include infections, lead-related problems, cardiac tamponade and rarely, perforations leading to complications such as pneumothorax .
• A subcutaneous cardioverter device (SCD) may be better than an ICD for some people, especially if they have a high risk of infection because of diabetes or other conditions. SCDs may also be safer for younger, active people who have a higher risk of cardiac arrest caused by a malfunction of the ICD (called lead failure). SCDs are not right for people who need pacemaker support.
• A wearable cardioverter device (WCD) may help people as they wait for a procedure to implant an ICD or SCD or for a heart transplant. If your provider needs to replace your ICD or SCD because of an infection, they may recommend a WCD until the infection heals. WCDs can also help keep people safe if they recently had bypass surgery or just started medical treatment for severe cardiomyopathy.