The lack of CPR training in the lay population is a big factor in the abysmally low survival rates for out-of-hospital heart attacks
When it actually happened, Robert Brodey could hardly believe it. Sitting in a pizza joint in Queenstown, New Zealand, not a month after taking a CPR course in Canada, a man appeared to be having a heart attack. His first thought, as he saw the man’s head bob down to the table, was that he was vastly unqualified to help. But when it became clear complete chaos was erupting, Brodey flew into action.
“I made an assessment that he wasn’t choking [the victim showed no signs of airway distress, like clutching his throat, before passing out] and that he was completely unresponsive.”
Yet he barely remembers much else—he can’t recall if he checked for signs of breathing, a key CPR step, before starting chest compressions. “I literally blanked about what you’re supposed to do,” he says.
Blanking is typical since most of us have little call to use our CPR training—which is a good thing. Yet the statistically low likelihood of needing resuscitation skills may also explain why few people learn cardiopulmonary resuscitation, the front-line first-aid protocol used on people who’ve stopped breathing and lost consciousness. And that’s not a good thing since, simply put, CPR helps saves lives.
Cardiac arrest—defined as a heart that has stopped beating—has many causes. While most are due to pre-existing conditions like cardiovascular disease, other culprits include electrocution, suffocation, overexertion, drowning and injuries, especially to the chest. (A heart attack can also lead to an arrest—it occurs when blocked or constricted arteries restrict blood flow to the heart.) Contrary to popular belief, CPR alone rarely restarts a stopped heart; it artificially pumps the heart and keeps blood circulating.
“If you do absolutely nothing, the probability of survival declines by seven to 10 percent with each passing minute [after the heart has stopped],” says Zambon.
In fact, every second counts—as soon as the heart stops, there’s no oxygenated blood getting to the vital organs. Without oxygen, organs, especially the heart and brain, start to die and even if a victim survives, they’ll likely sustain permanent damage. As a CPR first-aider, says Zambon, you’re assuming the function of the lungs and heart for a victim until medical help arrives.
Rarely will a person awake “like on TV,” she adds, so don’t get discouraged when it doesn’t happen. And don’t worry about breaking a rib or inflicting injury when doing chest compressions. A stopped heart is about as bad as it gets for us humans.
One hugely compelling reason to learn CPR is that statistics show most heart attacks and cardiac arrests happen in the home, and to someone you love or know. Taking action is about giving that person the best, if not only, chance of survival.
There’s some good news about survival rates, however. Zambon says in places where CPR is used in conjunction with automated external defibrillators (AEDs), rates can be as high as 50 percent. An AED is a portable machine that can deliver an electric shock to reset the heart’s proper rhythm. They’re incredibly safe and easy to use—a shock is only administered if the machine deems it necessary.
There’s now a movement to get AEDs in as many public spaces as possible, but until that happens, knowing proper first-aid protocol is your best bet. What does that mean exactly? Well, for starters, as a traveller you should always find out the 911 equivalent for the place you’re visiting; when someone is unresponsive, call for emergency assistance before you do anything else. Then, if they’re not breathing, start CPR. As a bystander it’s not relevant to know the medical problem; just take action and hope for the best.
Don’t know CPR? Plan for some CPR training while planning your next trip. A course is probably best; you’ll get a chance to practise on an AED. But another way is to get the CPR Anytime Family and Friends Personal Learning Program through the Heart & Stroke Foundation—it’s a fantastic self-teaching tool that allows you to learn CPR at home, and it includes a DVD and an inflatable doll so you can practice as often as you want.
What happened to Brodey’s patient? He survived! Brodey’s action, though imperfect, saved a life. “In the kingdom of the blind,” he learned, “the one-eyed is king.”
How to do CPR
Check for hazards around victim: is there glass, gas, traffic, any other danger to yourself?
Test for responsiveness of victim: tap on shoulder, call out
If unresponsive: if alone, yell for help or call 911 (or country’s equivalent); if not, ask someone else to call 911, and tell them to look for automated external defibrillator (AED) in the vicinity
Look, listen and feel for breathing: lay victim on back, put your hand on forehead to tilt back head, lift chin gently; get close to face, listen, feel for signs of breathing for five to 10 seconds (gasping isn’t breathing); look at chest to see if it’s rising
If no breathing: pinch victim’s nostrils, put your mouth over victim’s, give two breaths; look after each to see if chest has risen
Open shirt to skin, begin chest compressions: put heel of one hand between victim’s breasts or nipples (middle of breastbone), put other hand on top and interlock fingers; push hard, push fast, about 2 inches (4 to 5 cm) deep; let chest recoil back between each one
Do five cycles of this two-breaths/chest compressions protocol, then stop to check for breathing. (If none, continue CPR until AED or EMS personnel arrive.)
To use an AED: turn machine on; listen for voice prompts; attach pads to chest; AED will tell you when to press shock button, if necessary
Note: This is a guideline only. Always get individualized advice from a qualified health professional.