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A cardiac arrest is defined when the heart stops beating, the person stops breathing and the brain shuts down due to lack of blood flow. It's been estimated that there are over 1 million cardiac arrest events that take place in North America and the European Union per year. Cardiac arrest, which is synonymous with death from a clinical point of view, is a potentially salvageable situation and thus, in the early stages when people have died, it may be possible to restore blood flow and restart the heart through medical intervention and thus bring the person back to life.

Medical studies have shown that after attempts to restart the heart, it is possible to reactivate the heart in around about 20% to 50% of the cases. However, sadly, those people who've originally been revived still die due to various complications. Actual survival rates to discharge from hospital are much lower. In the cases in which a cardiac arrest had taken place outside the hospital setting, survival rates to discharge may vary from 1% to 15%. And in cases of cardiac arrest that take place in hospital settings, discharge rates are best around 25%.

The return of spontaneous circulation, ROSC, is the resumption of sustained cardiac activity associated with a significant respiratory effort after a cardiac arrest. Signs of ROSC include breathing, coughing or movement and a palpable pulse or measurable blood pressure. Cardiopulmonary resuscitation and defibrillation increase the chances of ROSC.

Following the initial recovery of a heartbeat after resuscitation attempts, which may take place in up to 50% of cases, there is significant damage that takes place to the vital organs of the body, such that the majority of the people eventually die from these complications. It's estimated that one-third of cases die from a brain or neurological damage, one-third die from heart or myocardial damage and the other third die from various inflammatory processes that have taken place.

In the brain, it's been shown that oxygen levels that are stored within cells rapidly deplete within around about two minutes to reach a point which they reach zero. Furthermore, at the same time, there is a rapid depletion of energy stores and this leads to accumulation of toxic materials that no longer are being cleared out of the cells. These include molecules such as lactate and acid. There is massive cell damage and ultimately cell death as a consequence of these processes. From a first aid perspective, there's not much we can do for future brain damage but we can monitor and manage the patient's health. When someone is breathing, we need to monitor their breathing and pulse. Monitor their blood pressure and oxygen saturation if possible. Give oxygen to the patients, place them in the recovery position, be ready in case the patient goes into cardiac arrest again and give as much information to the medical professionals, and this can include downloads from the data on your AED unit.