Casualties always make headlines, only their causes differ. While emergency response services have considerably improved, many victims still die en route to hospital, for want of immediate medical aid. Cardio pulmonary resuscitation or CPR is an universally requisite procedure that can transform helpless bystanders to life-savers.
An emergency procedure, CPR is a vital feature of general first aid training and disaster preparedness. CPR is vital to ensure the brain, arguably the most important organ of the body, does not have its supply of oxygenated blood cut off. CPR done outside hospitals should be followed by medical attention. Though students and non-medical persons are trained in CPR, how many perform during emergencies is a question mark.
Gap between training and performance
CPR is part of 12 intensive first –aid training imparted by St.John’s Ambulance, an internationally recognised authority in first aid training. “There is no follow-up to find out how many put CPR to good use. Few participate in refresher courses,” says Vasanthakumar, secretary, St Johns Ambulance, Manapparai division. Training by institutions is sometimes done perfunctorily and everyone does not get hands-on training. “Most training sessions use dummies. CPR training must be done on a real person to gauge heart beat and pulse,” says R Subramanian, certified first aid lecturer and trainer, who has close to three decades of experience. “There have been many instances where a person brought unconscious to the hospital after a heart attack has been revived through CPR,” says cardiologist N.Senthilumar. In certain developed countries, automatic external, defibrillators that revive heartbeat are positioned in public places.
ABC of CPR
The administration of CPR is encapsulated as ABC- airway clearance, breathing restoration and circulation by chest compression. The initial step is to determine if the individual is breathing by placing the ear to nose. In case breathing has stopped, artificial respiration, preferably by mouth-to-mouth resuscitation is called for.
Tilt the head upward, pinch nose to ensure air blown does not escape through nose and open mouth by nudging lower lip apart, instructs Mr. Subramanian. “Blow air 10 times per minute and the person will recover in at least two to three minutes as one litre of air is transferred. Air must be blown like inflating a balloon, not blowing a pipe.”
What happens if the individual remains unconscious even after resuscitation? External chest compressions by locking left hand with right hand and pressing downward on the heart must follow. It is essential to zero in on the spot between the breasts as this would stimulate the ventricles of the heart that pump blood. Compressions must be in synchronization with the heartbeat.
Only chest compressions
Recently, the American Heart Association revised fundamental guidelines for CPR, rearranging the acronym as CAB, putting chest compressions first.
This technique, can aid even untrained persons who can practise chest compressions alone. In case of stoppage of heart beat with normal breathing, resuscitation can be ruled out and chest compressions performed. In certain cases like electric shock, where heart failure may precede cessation of breathing, chest compressions are first called for, says Mr.Subramanian.
Many people refrain from performing CPR to avoid being embroiled in police enquiries.
Citing the Motor Vehicles and a Supreme Court judgment passed in 1989, Mr.Subramaniam says there is no need to wait for arrival of police to arrive on the accident scene to perform first aid on victim.
Not may corporates come forward to introduce CPR training in workplaces, save a few factories. Even in such cases, training is done as a mandatory exercise to comply with first aid regulations espoused by the Factory Act. “It is not enough to train students; we need performers who would put CPR into practice. Educating vendors and shop-keepers at bus stands and railway stations may help,” Mr.Subramanian suggests.