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As my family was home celebrating the holidays, I was pulling a shift in the ED.  While I tried not to think of them playing games and drinking hot chocolate, I heard the paramedic call in—an infant suddenly stopped breathing after choking on a new Christmas toy.  The parents saw him turn red, then blue, right before their eyes.  Fortunately, the mother was a teacher and had received some training in CPR.  She had the presence of mind to give the appropriate back thrusts, and was ready to begin CPR if needed.  She then saw her infant cough up the toy, and slowly regain his color, his normal activity, and a true tragedy was averted.

Later that night, a 55-year old male was brought in after family and good friends saw him collapse and stop breathing.  No one in his family knew CPR and chaos started to build.  Fortunately, one of the dinner guests had learned CPR in his lifeguard training, and instructed the others to call 911 while he began compressions.  He continued to do CPR until the paramedics arrived and brought him to the Emergency Department.  At the ED, we diagnosed him as having a major heart attack and immediately activated the cardiac catheterization lab.  Again, the willing hands of someone with minimal medical training saved a life.  This is something you too can learn.

In the most recent guidelines from the American Heart Association, there was a BIG CHANGE: the AHA now states that compression-only CPR is as effective at maintaining blood flow and good outcomes as compression plus mouth-to-mouth breathing, so the breathing (often a big impediment to doing CPR on a stranger) is no longer required in adults.  (The AHA still advises conventional CPR of compressions and breaths for infants, children, drowning victims, and people who seem to be having difficulty breathing).

CPR is lifesaving, and it is simple.  The key to successful outcomes with CPR is to DO IT. And DO IT CORRECTLY.

To learn CPR, you can take a class in your area (www.redcross.org/takeaclass), or also visit the American Heart Association’s www.handsonlycpr.org website to see helpful videos and instructions.  I’ve outlined the highlights of CPR below, but to really learn it, you should visit one of the above sites.  You can also take one of the AHA’s 22-minute “CPR anytime” courses online at home. http://handsonlycpr.org/resources.

Key Components to CPR:

  1. If you see someone collapse, call 911 (or have someone else call if you are not alone).
  2. Check for a pulse—feel your own neck, or your wrist—feel your pulse? It’s the source of life.  This is where you should feel on a collapsed person.  If you feel a strong pulse they likely do not need CPR, but check often so you can react quickly if they lose their pulse.
  3. If there is no pulse, start CPR.  Intertwine your hands and push firmly on the center of the chest
  4. Sing “Staying Alive”.  I’m not kidding. Since most of us do not have a metronome in our head, giving compressions at the correct 90-100 beats per minute can be challenging.  A study found that the disco song “Staying Alive” was pretty close to the beat that we should be compressing.  So do that.  Hum the song in your head, compressing to that beat.

When I was an intern, I remember my senior resident telling me “when you go to a [cardiac arrest] code, the FIRST thing to check is YOUR OWN pulse”.  These events are terrifying.  So, remember to breathe.  I’m sure that I didn’t at the first few that I saw.  That’s why part of residency training was to practice.  I practiced on mannequins, I helped out in real codes, I read and ran scenarios in my head.  All of this prepared me to lead our medical teams in codes in real life, where the stakes are far higher and the adrenaline running at full blast.  Do this yourself.  Run through the above list in your head; take an online class or an in-person class.  Drill these things into your mind, so that when it is the life of a loved one and you cant think straight, you can remember this

(1) Call 911

(2) start CPR

thus enabling you to (3) save their life.

Make your resolution this year to educate yourself on this simple, life-saving practice.  Drill it into your head and make a point of reviewing it every year in December or January.

I guarantee you, it will be the best resolution you can make and the greatest gift you can give.

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2 Comments

  1. Great summary of a truly life-saving topic!
    For a phenomenal examination of the underlying evidence for CPR and ACLS, check this out: http://www.smartem.org/podcasts/smart-cardiac-arrest-pharmacotherapy

  2. Alicia Perkins

    Darria, these are fantastic words of advice. I think why most parents aren’t CPR certified is due to medical ignorance. I know this sounds quite insulting. Perhaps most are terrified at the thought of ever having to place themselves in this situation. More data and more opportunity for community education may increase awareness and save lives!

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