You are a Lifesaver: How to Perform Cardiopulmonary Resuscitation (CPR)

Earlier this year, in the USA, a 9year old boy saved a 2month old baby’s life by teaching the mother how to perform CPR. The baby had stopped breathing and the mother could only scream and scream and perform incorrect CPR. Her 9yr old neighbour who, thankfully, happened to be there calmly guided her through correct CPR process on the baby. The baby’s breathing returned and soon, paramedics arrived to take over from the mum. The baby survived! When the young hero was asked how he learnt to perform CPR, he told them he memorized the steps illustrated on a cafeteria poster at his elementary school!

What are the statistics?

The numbers are quite disturbing as cardiac arrest is a leading cause of death in many places. In the US alone, about 900 adults suffer sudden cardiac arrest each day and 92% of them die before they reach the hospital (if this is the US, you can assume what the stats would be here in Nigeria). Although sudden cardiac arrest usually occurs in 60year olds and above, it should be noted that any age group can be affected.

Also, since about 75% of cardiac arrests occur in people’s homes, if you ever witness a cardiac arrest, it will most likely be in someone you know; probably a relative or friend. Performing a cardiopulmonary resuscitation on such person can significantly improve their chances of survival and buy time till advanced emergency medical care is available.

What is Cardiopulmonary resuscitation (CPR)?

CPR means saving lives. It means ‘raising the dead back to life’; which if done correctly and on time, does not require supernatural powers. Do you remember that part in ‘Matrix’ (the movie) where Neo dies but was revived when he was given the ‘kiss of life’? That was CPR! Of course, you know I don’t mean that in the literal sense.

In simple terms, Cardio = Heart. Pulmonary = Lungs. Thus, CPR implies Heart and Lung Resuscitation. It is a series of lifesaving actions that improve the chance of survival following a cardiac arrest.

Considering the details involved in CPR, this piece is focused on outside-hospital CPR done by untrained lay people. Before you grumble about how this does not concern you, let me state that  you don’t want to be one of those peeps in Nigerian movies who only cry and cry without attempting CPR when someone suddenly collapses and goes into cardiac arrest. Remember that ‘a little CPR’ is better than ‘no CPR’, the little CPR you do as a layman can be all that makes a difference. Take this chance to know something about CPR.

STEPS IN CPR: DR. CAB

Ø  D: Danger

Ø  R: check for Responsiveness.

Ø  C: Chest compressions

Ø  A: Airway

Ø  B: Breathing

D for Danger

The first step in CPR is to eliminate or minimize danger to both rescuer and victim. You shouldn’t be doing CPR in a burning house filled with smoke or in the middle of a highway. The victim should be safely moved to a safer place before you commence CPR. Otherwise, the rescuer may soon be in need of CPR too.

R for Responsiveness

You don’t want to commence CPR on someone who was only having a quiet nap. So before concluding that a person is in cardiac arrest, assess for responsiveness of the person. Shake and shout out to him/her. Tap the person’s shoulder and shout ‘are you OK?’ If they are unresponsive or if gasping, move to the next step of CPR. If ever in doubt, commence CPR. It is better to be wrong than to delay.

When do you go for help?

Do you first grab a phone and call for emergency medical help or do you start CPR immediately? I’ll make this simple.

If there is more than one rescuer present, one can start CPR while the other goes for help. However, if the victim is an adult who is known to have a heart disease, call for help first before you commence CPR, even if there is only one rescuer. In all other situations, for example, in children and victims of drowning, commence CPR for 2 minutes immediately after confirming the patient is in cardiac arrest before calling for help.

It cannot be overemphasized that a key component of ensuring successful CPR is to ensure minimal interruptions.

Before C

Before moving to C. Place the victim on a hard surface, a board on the floor will do. Doing CPR on a mattress reduces its effectiveness.

C for Chest Compressions

For adults in cardiac arrest outside the hospital, high-quality chest compression-only is what is recommended. So let us take a look at the technique for chest compression:

Ø  Put your hand in the centre of the person’s chest between the nipples.lace one hand on top of the other.

Ø  Perform chest compressions at the rate of at least 100 per minute.

Ø  Compress the chest to a depth of about 4-5cm.

Ø  Allow full recovery after each compression.

Ø  Avoid interruptions

 

 

In lay untrained persons, all we want is high-quality chest compressions done well until emergency medical service arrives. However, newborns, children, and victims of drowning will benefit from additional activities including giving of rescue breathing.

So far, I have itemized DR C of DR CAB. In my next post, I will take us through AB to complete the CPR process. Until then, I look forward to questions and comments from you.

For now, if all you can do is deliver high-quality chest compressions, you are already able to deliver CPR to many adults. One day, you just might make the difference between dying and ‘living again’.