The proportion of people with cardiac arrest who receive bystander cardiopulmonary resuscitation (CPR) before an ambulance arrives remains suboptimal, sources close to Mater Dei Hospital told Times of Malta.
This is disappointing considering the substantial effort over many decades to promote bystander CPR. Reasons for the public not starting resuscitation include fear of infection or litigation and the complexity of conventional CPR.
Whether or not the 1990s Spanish dance hit La Macarena is in your favourites folder, it could be the key to helping save a life. Experts earlier this month revealed that using the song to keep time improves the quality of chest compressions during CPR.
The tempo of the song, released by Los Del Río in 1995, helped people keep a steady rhythm while carrying out the life-saving technique, a study found.
Researchers compared the rate and depth of chest compressions carried out by 164 students on a mannequin over a two-minute period – some of whom were asked to sing La Macarena in their heads as they did so.
Others were provided with a smartphone app which made a noise at 103 beats per minute, while a third group were given no guidance at all.
The study found that those in the La Macarena group performed nearly three-quarters (74 per cent) of compressions at the recommended rate of between 100 and 120 beats per minute. Those using the app fared better, achieving 91 per cent in the target range, but were the slowest to start the first compression.
The group who were given no external guidance had an average percentage of just 24 per cent.
No group achieved the necessary compression depth of five centimetres.
“CPR is a simple technique which can save a person’s life in case of a cardiac arrest,” say Michael Spiteri, consultant at the emergency department at Mater Dei and Tanya Esposito, consultant anesthetist at the hospital.
“In its simplest form, this means that a first aider will put the palms of his hands on the central part of the patient’s chest and applies a compressive force at a rate of about 100 times a minute,” Dr Spiteri and Dr Esposito add.
The rate, depth and timely application of these compressions are critical in delivering good quality CPR and a number of studies have shown that this plays a very significant role in the chain of survival.
The tempo of the song helped people keep a steady rhythm
“However, one major weak link in this process is the experience of the CPR provider; in the case of laypersons, panic usually sets in and, as a result, the rate of the chest compressions is higher than that being recommended,” the consultants emphasise.
Simple aide memoirs have been developed so that inexperienced rescuers can time themselves to the right rate while also keeping their cool when faced with such a stressful situation.
“Up to a few years ago, we used to time ourselves to the tune of Staying Alive by the Bee Gees, but as years have gone by, the number of rescuers who are of the age to remember this 1977 song has decreased,” points out Dr Spiteri.
“Therefore, this study focused on a new tune which is relatively more recent. The study also compares this to apps which can emit a sound at 100 beats per minute. The downside was that the depth of compressions was diminished as they concentrated only on the rate,” he continues.
“In reality, the main message of this study should be that sudden cardiac arrest is a relatively common occurrence and CPR will go a long way to decrease the number of avoidable deaths and improve the neurological outcome,” adds Dr Esposito.
“CPR training is an inexpensive and easy skill to grasp and our advice is that everyone should be taught on how to perform such manoeuvres. One such way to increase the uptake of these courses is that of incorporating them in school curricula, which certain schools are already doing, before they are included in our national curriculum or as a pre-requirement for common activities, for example, vehicle driving training,” they say.
The authors of the Macarena study concluded: “Both the app and using mental memory aid La Macarena improved the quality of chest compressions by increasing the proportion of adequate rate but not the depth of compressions. The metronome app was more effective but with a significant onset delay.”
The research was carried out by a team at the University of Barcelona, Hospital Clinic Barcelona, and Universitat Autonoma Barcelona in Spain, and was led by Enrique Carrero Cardenal. The findings were presented at an Euroanaesthesia congress in Copenhagen, Denmark.