Statement on
“CPR training and Public Access Defibrillation
in Latin America and the Caribbean”
Cardiac disease remains the number one killer of adults in all of the Americas. One of its
manifestations, cardiac arrest, occurs frequently worldwide and affects people mainly
after the 4th decade of life. It is estimated in the US that over 250,000 people die annually
of sudden cardiac arrest. In the vast majority of cases the main cause of cardiac arrest is a
ventricular arrhythmia, the terminal rhythm being ventricular fibrillation (VF) or
pulseless ventricular tachycardia (VT). Terminal rhythms can be treated and the heart
”restarted” with an electric shock in a process called defibrillation. Science has shown
that the greatest chance of survival results when the interval between the onset of
ventricular fibrillation and tachycardia and the delivery of electrical defibrillation is as
brief as possible. Every minute the heart spends in a terminal rhythm decreases the
chance of survival after defibrillation by 10%. Cardiopulmonary Resuscitation (CPR) is
necessary to provide vital circulation to important organs before defibrillation is achieved
as these terminal rhythms result in absence of output from the heart.
The recognition of potential lethal rhythms in the past has demanded the diagnosis by
health professionals. Fortunately, technology has provided an automatic method to
diagnose and treat these rhythms and deliver an electric shock if needed, thus, replacing
the requirement for diagnosis by an operator. This device is called the Automated
External Defibrillator (AED). Time-honored algorithms have proven that the diagnostic
capability of an AED is almost 100% in determining accurately the decision to shock or
not to shock the victim.
Ventricular and pulseless ventricular tachycardia affects people everywhere, so it is
imperative to have CPR training for the general public and response professionals as well
as access to AEDs in places where large numbers of people gather, such as, stadiums,
shopping centers, airports and airplanes, train stations, bus stations, cruise and cargo
ships, and multi-cinema facilities. As many cardiac arrests happen in the home, it is
imperative that families of cardiac patients are trained in the recognition of the signals of
a heart attack, how to access emergency services and how to apply CPR if required.
The InterAmerican Heart Foundation supports and recommends the training of persons in
accredited courses in CPR and AED use and the placing of AEDs in public places,
mobile rescue teams, in-hospital non specialized units, and diagnostic facilities, and urges
that such actions be taken in the context of strengthening all aspects of the chain of
survival.
Finally, recognizing the chronic economic challenges experienced by Latin American and
Caribbean countries and the proven cost effectiveness of prevention programs of heart
disease, the IAHF recognizes the obligation of governments of the region to continue to
develop well-balanced investment policies for health resources in which heart disease
prevention is made a major priority and CPR training and Public Access Defibrillation
made more widely available.
More information
The InterAmerican Heart Foundation is an organization that brings together all the
National Resuscitation Councils of Latin America and the Caribbean and has as its
mission to ”to reduce disability and death from cardiovascular and respiratory
emergencies and stroke by improving the chain of survival in every community in Latin
America and the Caribbean.”
For more information or questions, please contact:
Dr. Daniel Pichel (Panamá) d.r.pichel@mac.com
Dr. Raffo Escalante (Perú) raffo.escalante@gmail.com
Dr. Saúl Drajer (Argentina) sdrajer@intramed.net.ar
Dr. Santiago de los Santos (Uruguay) sacha@chasque.apc.org
Dr. Manoel Fernandes Canesin (Brasil) mcanesin@sercomtel.com.br
Note: originally published in 2004, revised 2013.