Why you should learn to do CPR
Last week I attended a ‘‘refresher’’ course on CPR – cardiopulmonary resuscitation for those not familiar with the acronym. There is no disputing the value of CPR – if done in a timely and effective way, it undoubtedly saves lives. But despite this, the majority of us don’t know how to do it, and don’t feel confident stepping in if needed in an emergency.
Having attended this course, I can reassure you – there is no need to worry about CPR. It is now well recognised that prompt use of good chest compressions, and using a defibrillator machine as early as possible, is all you need to get your head round. Yes – if you are a trained CPR giver, or there are plenty of you to do different roles, it might be beneficial to also do ‘‘rescue’’ breaths, but by far the most important thing to focus on is the chest – by doing regular, deep, fast compressions, you enable blood to circulate around the body, keeping the vital organs alive and oxygenated until medical help is available.
CPR can be performed in all sorts of medical emergencies – drowning, electrocution, infection, collapse, severe strokes. In fact any event that renders a person unresponsive and not breathing. But by far the most likely situation to need CPR is a massive heart attack, leading to cardiac arrest.
In cardiac arrest, the heart stops beating in a normal rhythm, thus preventing the effective flow of blood around the body. If the heart rhythm isn’t restored to normal rapidly, the heart muscle will die, making recovery unlikely.
Cardiac arrests are all too common. In the Wellington region alone, about four people a week will have one. Men are twice as likely as women to experience cardiac arrest, due to their higher rates of heart disease. The most common age range for cardiac arrest is the mid to late sixties, but even children can suffer from them, though usually as a result of trauma rather than because of a heart problem per se.
Back in the day, CPR was taught as an ‘‘ABC’’ process – airway, breathing, circulation. But since the realisation that by far the most important parts of CPR are the chest compressions and early use of a defibrillator, this has changed to ‘‘DRS ABCD’’. This new acronym recognises the need to send for help (and hopefully get the use of a defibrillator) and start chest compressions as early as possible.
So how do you do a good chest compression? Well, although it is definitely tiring if you have to do it for many minutes, its not that hard – you place one hand on top of the other, fingers interlocking, over the centre of the chest. Then you push directly down into the chest, hard and fast. The rate needs to be around 100-120 beats per minute, and you need to push into the chest wall about 5 centimetres – deeper than most people imagine. You are trying to mimic an artificial heart, and as untreated cardiac arrest is fatal, even if you don’t do a perfect job, you are the only chance of survival at that stage.
The advent of automated external defibrillators (AEDs) has transformed survival rates after cardiac arrest. If good chest compressions can take over the role of the heart temporarily, a shock from an AED can revert the heart back to its normal rhythm and allow it to function again. AEDs are now available in thousands of locations around the country, and the app aedlocations.co.nz will direct you to your nearest one in an emergency – I would recommend putting it on your phone. AEDs are easily portable, and come with such simple instructions I suspect my 11 year old could use one if needed. You place the soft pads on the persons chest, and turn on the machine, and it basically does all the rest for you. When used immediately after a cardiac arrest, AEDs increase survival by 80 per cent.
Over the years I have heard some incredible stories of lives being saved by CPR – turning bystanders into heroes. If you are reading this and don’t feel confident in doing it yourself, I would urge you to enrol in a course – don’t put it off! Even better, organise one for all your work colleagues … you never know when it might be needed. If you live in the Wellington region, Heartbeat provides free CPR training for anyone, via Wellington Free Ambulance. If you live elsewhere, I would recommend St John or the Red Cross.
❚ For more information visit wfa.org.nz/heartbeat, stjohn.org.nz/First-Aid, redcross.org.nz/first-aid. or http://nzrc.org.nz/
❚ Dr Cathy Stephenson is a GP and medical examiner.