Community Health

World Record in Hands-only CPR 10

KK Aggarwal

Abstract
Heart Care Foundation of India, a not for profit NGO created a world record on the eve of the World Health Day on 6th April
2012 when the Foundation through its President Dr KK Aggarwal, Padma Shri & Dr BC Roy National Awardee trained 11,459
people in hands-only Cardiopulmonary Resuscitation (CPR 10) in one day surpassing the previous record of training 7909 people
in one day by Singapore Heart Foundation. The training was organized at Dr Sampumanad Sarvodaya Kanya Vidyalaya No. 1,
C-l, Block-C, Yamuna Vihar, East Delhi. The records were: Maximum number of people trained in hands-only CPR in one day by
an individual and by an NGO and also the first to reach a training target of 10,000 in one day by an individual and by an NGO.
Keywords: CPR, hands-only CPR, cardiopulmonary resuscitation, records, medical record

S
udden cardiac arrest (SCA) refers to the sudden
cessation of cardiac mechanical activity with
hemodynamic collapse, most frequently due
to sustained ventricular tachycardia/ventricular
fibrillation. These events mostly occur in patients
with structural heart disease (that may not have been
previously diagnosed), particularly coronary heart
disease.
The event is referred to as SCA (or aborted sudden
cardiac death) if an intervention - hands-only CPR
or defibrillation or spontaneous reversion restores
circulation. The event is called sudden cardiac death,
if the patient dies.
The administration of CPR by a layperson bystander
(bystander CPR or bystander-initiated CPR) is
important in determining patient outcome after out-of-
hospital SCA.
Survival after SCA is higher among those who have
bystander CPR when compared with those who
initially receive CPR from EMS personnel. Also, early
restoration or improvement in circulation is associated
with better neurologic function among survivors.1
For adults with sudden out-of-hospital cardiac arrest,
compression-only bystander CPR (without rescue The 2010 American Heart Association (AHA)
breathing) has equal or possibly greater efficacy guidelines for CPR recommend that bystanders
compared with standard bystander CPR (compressions perform compression-only CPR to provide high-quality
plus rescue breathing). chest compressions prior to the arrival of emergency
personnel.2,3
Initial observational studies that evaluated the
Padma Shri & Dr BC Roy National Awardee
President Heart Care Foundation of India
delivery of compression-only CPR versus standard
E-mail: emedinews@gmail.com CPR including rescue breathing found no significant

686 Indian Journal of Clinical Practice, Vol. 23, No. 11 April 2013
 Community Health

differences in survival or long-term neurologic function

between the two groups, suggesting that compression-
only CFR could be safely delivered.4,7

METHODS AND OBSERVATIONS

The Foundation planned a CPR Utsav (festival) on the

eve of World Health Day falling on 7th April, 2013 with
a target of training 10,000 people in a day. Four hundred
manikins were arranged. A school was identified in
East Delhi as the hot school. A total of 32 schools were
earmarked for the day of the event. Prior permission
was taken from the Dept. of Education, Government
of Delhi. A pre-event sensitization was done for all
schools and their principals. Pre-event confirmation
of students was taken from various schools. A total of
13,000 entries were received.
A dropout of 10% was envisaged. On the day of event,
a total of 11,459 students and teachers were trained.
To make the event lively, every session of CPR was
intermixed with the presence of a celebrity that
included politicians, bureaucrats, administrators and
heads of medical association, etc. Children were trained
in batches of 400 each with single-rescuer CPR training
or 800 each with two-rescuer CPR training. Complete
training was provided to all students.
Every child who underwent training signed an
attendance sheet. Two independent observers certified
the whole event apart from multiple celebrities, who
also certified the number and the process.
Over a hundred manikins were damaged in the intense
heat.
The mantra taught was Marne kc dus minute ke bheetar
(jitna jaldi utna behtar) kam se kam agle dus minute tak
(jitni der tak ho utna behtar) apui chhati -peeine ke badle
mare hue vyakti ki chhati peeto.
It was this last phrase apni chhati peetne ke badle mare
hue vyakti ki chhati peeto that proved to be catchy and
made it easier for people to recall the Mantra. When
the children were interviewed after the training, more
than 80% could recall the mantra only because of this
last phrase.
The English version of this Mantra Within 10 minutes
of death (earlier the better) for the next 10 minutes (longer
the better) continuously and effectively compress the center
of the chest of the deceased person has not been successful
due to its low recall value.
On 6th April 2013, on the day of the Utsav, we named
this Mantra as Savitri Mantra similar to the Gayatri
Mantra. Savitri Mantra, therefore, teaches us how to
save life after a cardiac arrest.

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Community Health

DISCUSSION Heart Association Guidelines improves outcomes

With proper planning and execution, it is possible
to conduct any big awareness-cum-training event in
the country. One should always anticipate a 10-20%
dropout and plan accordingly. Records are always
made to be broken but if you are the first to cross 10,000
mark, this type of record will always remain intact.
LESSONS LEARNT DURING SUCH A CAMP for the public from the American Heart Association
Imported manikins do not last long in Indian
circumstances. Either they get heated up in summer
or they break early in the cold weather.
Children should be taught and emphasized not
to practice CPR 10 on live people as it can break
the ribs and harm the heart health. This was the
commonest question asked by the cliildren in the
Utsav (Can they practice at home?).
CONCLUSION
The word CPR 10 has been so created so that the people
find it easy to remember and is also based on the fact
that chances of reversibility of a cardiac arrest victim
are maximum in the first 10 minutes. I personally feel
that Savitri Mantra, which has a scientific basis, should
be adopted by the medical community and should be
recited in schools in assembly or when a large number
of students are available to listen,
REFERENCES Svensson L. Survival is similar after standard treatment
1. Aufderheide TP, Yannopoulos D, Lick CJ, Myers B, Romig
LA, Stothert JC, et al. Implementing the 2005 American
after out-of-hospital cardiac arrest. Heart Rhythm
2010;7(10):l357-62.
2. Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD;
American Heart Association Emergency Cardiovascular
Care Committee. Hands-only (compression-only)
cardiopulmonary resuscitation: a call to action for
bystander response to adults who experience out- of-
hospital sudden cardiac arrest: a science advisory
Emergency Cardiovascular Care Committee. Circulation
2008;117(16):2162-7.
3.
Field JM, Hazinski MF, Sayre MR, Chameides I.
Schexnayder SM, Hemphill R, et al. Part 1: executive
summary: 2010 American Heart Association Guidelines
for Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care. Circulation 2010;122(18 Suppl 3):
S640-56.
4. B
obrow BJ, Spaite DW, Berg RA, Stolz U, Sanders AB, Kem
KB, et al. Chest compression-only CPR by Iay rescuers
and survival from out-of-hospital cardiac arress. JAMA
2010;304(] 3):1447-54.
5.
SOS-KANTO study group. Cardiopulmonary
resuscitation by bystanders with chest compression
only (SOS-KANTO): an observational study. Lancet
2007;369(9565):920-6.
6. Iwami T, Kawamura T, Hiraide A, Berg RA, Hayashi Y,
Nishiuchi X et al. Effectiveness of bystander-initiated
cardiac-only resuscitation for patients with out-of-
hospital cardiac arrest. Circulation 2007;116(25):2900-7.
7.
Bohm K, Rosenqvist M, Herlitz J, Hollenherg J,
and chest compression only in out-of-hospital
bystander cardiopulmonary resuscitation. Circulation
2007;116(25):2908-12.

Heart Care Foundation President Trains Over 11,000 People in CPR

HT Correspondent Hindustan Times New Delhi, April 08, 2013
First Published: 00:26 IST(8/4/2013) 1 Last Updated: 00:27 IST(8/4/2013)
By training more than 11,000 people in cardiopuLmonary resuscitation (CPR) in a single day, Dr KK Aggarwal,
president, Heart Care Foundation of India, created a world record on Sunday.
In all, 11,459 people were trained that mostly comprised school children. The earlier record was,of training 5,000
persons.
The event was organized at the Dr Sampurnanand Sarvodaya Kanya Vidyalaya, Yamuna Vihar, on the occasion
of World Health Day.
CPR 10 is based on the mantra - Within 10 minutes of death (earlier the better) for the next at least 10 minutes (longer
the better), compress the centre of the cliest of the victim with a speed of 10x10=100 per minute, said Dr Aggarwal, who
! has trained 35,000 people so far.
More than 24 lakh people die in our country every year with sudden deaths and 18 lakh of thern die before
reaching the hospital. Around 12 lakh people can be saved if CPR 10 can be taught to even 1 per cent of the
society.

688 Indian Journal of Clinical Practice, Vol. 23, No. 11 April 2013