Cardiac arrest, tuwing kailan nga ba tumatama at ano ang dapat gawin bilang pangunang lunas?
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00:00 cardiac arrest is one of the most scary conditions because many people die from this condition if they are not taken care of early.
00:09 And now, we will have with us this morning Dr. Don Reyes. Good morning, Doc. Good morning, sir and ma'am.
00:21 We also have with us Jam. I am with him at the Philippine Heart Association.
00:26 Good morning, Doc. He is the chair of the CPR Council. Welcome to RSP.
00:31 What is cardiac arrest? And when is it possible to be attacked? We should be aware of this.
00:36 Okay. So, our topic today is cardiac arrest. But I just want to clarify that cardiac arrest is a general condition.
00:44 This is the most mode of exit of all the people who die. Cardiac arrest is when the heart stops.
00:50 But if we talk about cardiac arrest that happens outside the hospital or outside the house, this is what we call sudden cardiac arrest.
00:59 Because there are always stories that say, "What died?" Cardiac arrest.
01:03 All of us will die from cardiac arrest. The last thing that will stop is the heart beating.
01:09 Generally, that's called cardiac arrest. But the condition of sudden cardiac arrest is somehow different.
01:14 This is when the heart suddenly stops beating. Even if there is no heartbeat, you're feeling okay now,
01:21 then suddenly in an hour's time, you feel difficult in breathing, you have difficulty breathing, you have a stomachache, then you suddenly die.
01:28 So, that's what we call sudden cardiac arrest.
01:31 So, who is at risk in this condition?
01:36 Okay. What is scary here is that sudden cardiac arrest, there are many reasons for that, but it could happen to anyone.
01:42 Anytime, at any place. So, we should always be prepared.
01:46 But most commonly, the associated cause of sudden cardiac death or sudden cardiac arrest, we call it, is still a heart attack.
01:54 This is what is attacking the heart. This is still the most common.
01:58 But there are also many reasons. For example, this could happen to athletes.
02:01 You know, someone played football, his body got bigger, then suddenly he got a heart attack.
02:06 Does he have comorbidity? Does he have any underlying disease?
02:09 They don't know. That's why it's a sudden heart attack.
02:12 It could be that the heart has an electrical problem.
02:15 So, when we say electrical, it's the heart that is running electricity.
02:18 So, our heart also has a meralco.
02:20 If that happens, it's a short circuit.
02:22 Because of the predisposed individuals.
02:25 Even if you're healthy?
02:26 Even if you're healthy, suddenly, that's why it's called sudden cardiac arrest.
02:29 But again, the most common cause is still the heart disease.
02:33 So, many diseases are still very prone, but we don't exclude the populations prone to this one.
02:41 The athletes, actually, we say this to anyone.
02:44 So, it's really good that you always go see a doctor, have your health checked.
02:50 So, we can avoid these dangers.
02:53 Okay. So, Doc, how can we know if a person is experiencing sudden cardiac arrest, and what should we do?
03:01 Okay. So, what happens is, it's fortunate if there are symptoms before this happens.
03:07 But many things happen suddenly.
03:09 You're playing, you're shooting, you're dribbling, and suddenly, you lose consciousness.
03:14 So, others, what happens is, they have seizures, like convulsions.
03:18 But most of the time, when we say that there's a heart disease, because that's still the most common cause,
03:23 they have what's called chest pain.
03:25 So, you've heard, when doctors talk about angina, chest pain, the weight of the chest.
03:31 Usually, it's in the middle of the chest, not on the right, not on the left.
03:36 They have difficulty breathing, they sweat coldly.
03:39 This is the type where they can lose consciousness, they can have near-fainting spells.
03:43 Okay. So, those are the common symptoms that a person experiencing heart attacks can experience.
03:49 And in a few minutes' time, or in an hour's time, sudden cardiac death can happen.
03:54 Okay. So, one of the main things that a person experiencing cardiac arrest does is giving CPR.
04:03 Yes.
04:04 So, what's the right way to give CPR?
04:09 Okay, we have here, but let's first explain the principle of CPR.
04:13 Because when we say sudden cardiac arrest, the heart suddenly stops.
04:18 Even when you breathe, it can stop.
04:21 Pre-pandemic, what we recommend, of course, everyone knows that,
04:26 we give a pump, we give rescue breathing.
04:30 But since the pandemic, we have a problem with contagious diseases, with the disease.
04:36 So, we recommend what's called hands-only CPR.
04:40 Hands-only CPR.
04:42 Okay. This is designed for lay people.
04:45 Because when we give CPR, we call it basic life support.
04:49 This has training.
04:51 But what we believe is that every person can save their life.
04:56 That's why this is designed as hands-only CPR.
04:58 Like Luke, "Just my hands."
05:01 Okay.
05:02 So, our first thing, pre-pandemic, let's do three steps first.
05:05 Pre-pandemic, before COVID-19, we have what we call three C's.
05:13 The first C, check first if the person is unconscious.
05:19 Maybe he's just sleeping.
05:20 He's just tripping while sleeping.
05:21 The second is call.
05:24 If you know that he's not responding, he's unconscious, you have to call for help.
05:29 So, we have 911, etc.
05:31 And then the third C is compress.
05:33 This is when we do chest compressions.
05:35 We'll demonstrate later.
05:38 But because of the onset of the pandemic, many people are infected, there are diseases.
05:42 Even after the pandemic, we still recommend this because mouth-to-mouth breathing can cause disease.
05:48 The rescuer is pitiful.
05:49 So, we came up with the five C's.
05:51 The first one is still check, but you should check from afar.
05:55 Don't get too close.
05:57 And then if you're a bit unconscious, you're kind of sure that you need help, then you have to call again.
06:04 911, emergency, call a friend.
06:06 Okay.
06:07 The third C is cover.
06:10 So, now we recommend that you have to protect yourself.
06:13 And our victim, we can also cover it.
06:17 You don't need to wear a face mask.
06:19 We can cover it with a cloth.
06:21 Okay.
06:22 So that we can avoid aerosolization, the virus can enter the air.
06:28 You can cover it with a cloth.
06:30 Don't worry.
06:31 Even if it's covered, it won't affect the air flow.
06:35 The most important thing in this life-saving technique is to do chest compressions.
06:41 Okay.
06:42 And the fourth C is chest compressions.
06:44 Chest compressions.
06:45 Okay.
06:46 Five C's later.
06:47 When we do chest compressions, we should make sure that our hands are clasped.
06:53 Put the heel of the hand.
06:55 What is the Tagalog for heel of the hand?
06:56 What is this in Tagalog?
06:57 "Sakong ng kamay."
06:59 "Sakong ng kamay."
07:00 "Sakong ng kamay."
07:01 "Sakong ng kamay."
07:02 Okay.
07:03 Sorry, we won't use our feet.
07:05 Hands only.
07:06 Put the heel of the hand in the middle of the chest.
07:08 What we call in medicine is "sternum."
07:12 Okay.
07:13 Sternum.
07:14 In the middle.
07:15 Between the two chest.
07:16 What is that in Tagalog?
07:17 That's not there.
07:18 People call it "breastbone."
07:20 Breastbone.
07:21 And not in the chest.
07:23 Make sure it's not in the chest.
07:24 Because the heart is behind the sternum.
07:26 That's the breastbone.
07:27 Place one hand.
07:29 Make a clasp so that it won't slide.
07:32 And make sure that our shoulder is above the heart of the patient.
07:36 Or the victim.
07:38 Then what we do is we do a "bomba."
07:40 Chest compression.
07:42 So, how fast is the "bomba?"
07:44 It's not too fast, not too slow.
07:47 If we're going to count, in one minute,
07:49 100 to 120 pumps a minute.
07:52 We say that if you're in the right rhythm.
07:57 That has a song, right?
07:58 It has a song.
07:59 Of course, if you're an American, it's "Staying Alive."
08:01 Because you want to eat.
08:03 Okay?
08:04 You can't just stay dead.
08:05 You have to stay alive.
08:06 But if you're Filipino,
08:08 what we want to promote is Donald Cruz's song.
08:10 What is that?
08:11 "Kapag Tumibok Ang Puso."
08:13 You can follow along.
08:15 If we have something today, we can follow along.
08:17 Your rhythm is at 100 to 120 pumps a minute.
08:21 So, you're singing while you're pumping.
08:23 "Kapag Tumibok Ang Puso."
08:25 How long will we do this?
08:27 Two minutes.
08:28 Two minutes.
08:29 Two minutes straight.
08:31 So, don't push too hard.
08:33 Just right.
08:34 That's the right answer from Sir Aljo.
08:36 So, you should push around two inches.
08:39 Okay?
08:40 But if you hear a crack,
08:42 What will you do?
08:44 We won't do anything.
08:45 We'll just continue pumping.
08:46 What's the crack?
08:47 You might get a shock.
08:48 You might get a shock.
08:49 Because you're afraid of something else.
08:50 Especially if it's old.
08:51 It's already old.
08:53 So, just continue?
08:54 Just continue.
08:55 Because if you don't do chest compression,
08:57 it will surely kill you.
08:59 But we can fix that.
09:01 Okay.
09:02 So, what is more important is for the heart to pump.
09:05 It's more important than the fracture of the ribs.
09:07 If there's any.
09:08 Just don't push too hard.
09:09 Around two inches.
09:10 Around 2 to 2.5 inches.
09:13 Just that deep.
09:14 And then, the speed.
09:16 Don't push too hard.
09:17 Don't push too hard.
09:18 Just sing "Staying Alive."
09:20 Or "Kapag Tumibok Ang Puso."
09:22 How long does it take?
09:24 Two minutes.
09:25 If it's past two minutes,
09:27 and you're still conscious,
09:28 and the patient is still unconscious,
09:30 just continue.
09:32 If the consciousness is breathing or is already pumping,
09:35 or you've already been punched,
09:36 that means it's okay.
09:37 Okay.
09:38 If not, just continue until the rescue team arrives.
09:43 So, it's very important in the community that we have rescuers.
09:47 We have a rescue team.
09:48 If there's none, let's pray to the Lord.
09:51 We have an AED here.
09:53 Yes.
09:54 What is it?
09:55 That's the fifth C.
09:56 The first C is "Check."
09:58 The second is "Call."
09:59 The third is "Cover."
10:01 The fourth is "Compress."
10:02 The fifth is what we call "Connect."
10:05 Okay.
10:06 This means that this AED,
10:08 Jam, please demonstrate.
10:10 It looks like it's from a live cell.
10:12 The AED is a device that gives electricity to the heart.
10:16 Okay.
10:17 Because the heart, when it gets a cardiac arrest,
10:19 it's like a flat line.
10:20 Okay.
10:21 Flat line, or usually, the cause of a cardiac arrest,
10:25 is what we call ventricular fibrillation.
10:27 It's a high-tech term, but what it means is that
10:30 the heart is like convulsing.
10:32 It's like a short circuit.
10:34 So, what defibrillation does,
10:37 this current,
10:38 it gives a strong shock to the heart
10:41 so that the heart calms down.
10:43 If you calm the convulsing heart,
10:45 hopefully, it will recover on its own.
10:48 And then, after delivering this shock,
10:52 defibrillation, which is too medical,
10:54 shock or current,
10:56 the CPR will be resumed.
10:58 Okay.
10:59 Because you will help the heart recover and pump again.
11:02 And then, you check again if it's...
11:05 This is the last one, right?
11:07 Yes.
11:08 The good thing about AED is that it's smart.
11:12 If we attach the pads,
11:15 There are pads, right?
11:16 There are pads. Let's show them.
11:18 Let's show them.
11:19 There are pads.
11:20 I think the pads are missing here.
11:22 But AEDs are in different places.
11:25 This is a strategic area, right?
11:26 Yes. Supposedly.
11:28 In the Philippines, it's not widespread.
11:33 We still lack awareness.
11:34 That's why this is the advocacy of the Philippine Heart Association,
11:37 is to spread awareness and AED.
11:39 And hopefully, our government lawmakers
11:42 can come up with bills that will require the deployment of AEDs in public areas.
11:48 Especially in basketball tournaments,
11:53 or even just in subdivisions,
11:56 sports activities,
11:59 there should be people on standby.
12:01 Yes.
12:02 In public areas, first aid,
12:04 our responders have important equipment.
12:06 Sir Aljo, I'll ask you.
12:07 You're traveling.
12:08 How many can you see at the airport?
12:10 Supposedly, it's a cat.
12:12 There should be.
12:13 Let's check.
12:14 There are, but it's hard to find.
12:17 It's like Easter egg hunting.
12:19 You'll have to look for it.
12:20 We need it.
12:22 Yes.
12:23 To save lives.
12:24 In parks, in malls.
12:25 What's the recent death?
12:27 In prison, right?
12:29 The doctor who died.
12:31 In concerts, Chocolate, if you still remember.
12:34 Yes.
12:35 Sambo Elim, during a basketball game.
12:38 There are many.
12:40 So in high-risk areas, where there are many people,
12:43 AEDs should be deployed.
12:45 AED.
12:46 Automated External Defibrillator.
12:49 Defibrillator.
12:50 This is what they give in hospitals.
12:52 This is designed for the lay,
12:56 or for people outside the hospital to use.
12:59 To save a life.
13:00 Thank you very much.
13:02 Thank you.
13:03 Thank you.
13:04 Thank you, Dr. Don Reyes,
13:07 for sharing information about sudden cardiac arrest
13:11 and the right steps to take to make this condition better.
13:14 Jam, thank you very much as well.
13:16 You have many activities this month, right?
13:19 Yes, always.
13:21 The Philippine Heart Association.
13:22 We always train CPR.
13:24 Medical people, lay people,
13:27 we're always there to spread the knowledge
13:30 and help people gain the skills in saving a life.
13:32 Thank you, Dr. Don Reyes.