Any form of CPR is better than no CPR

Dr Vanita Arora

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The inaccurate dealing of medical information in television and movie screens leaves an indelible understanding in our minds almost impossible to remove. Although the objective of these media is to provide entertainment but their profound effect on human psyche is unparalleled. And therein remain considerable concern where people’s expectations and beliefs get formed due to the inaccuracies of these formats. Cardiopulmonary resuscitation (CPR) has been one of the worst victims of the misinformed and careless treatment on the celluloid. It is so often portrayed wrongly that a few hard-pressing on the chest and a single round of mouth-to-mouth brings the victim back to life.

What happens when one is drowning?

The reality is much different. CPR is used to save people who have suffered a sudden cardiac arrest, which can be caused by multiple factors. In movies and television programs administration of CPR is shown in cases when a person is saved from drowning. A drowning person suffers from the lack of oxygen. The blood also undergoes physical changes as well. In salt water osmosis makes the blood thicker by pulling water from the bloodstream into the lungs. In fresh water, something different happens, wherein osmosis acts in the opposing direction. As a result, the blood becomes diluted and thinner, red blood cells get destroyed, and electrical activity of the heart gets affected. Both the situations may trigger sudden cardiac arrest. For any person who has suffered a sudden cardiac arrest, CPR is the most important first-aid step, till emergency medical service arrives. It is important to know that CPR may not bring people back to consciousness. CPR is performed to pump blood and oxygen to brain. If heart is at standstill then to restart it one needs to administer electric shock.

Why CPR is essential?

When a person has suffered a sudden cardiac arrest, the key aspect is to hard-press the chest to keep the blood flowing and therefore keep the brain oxygenated. Breaking the rhythm to breathe-in oxygen will interrupt the flow of blood. In fact, the American Heart Association has removed mouth-to-mouth breathing as an essential part of CPR in adults. Mouth to mouth breathing is still recommended in the case of children.

CPR need not be perfect to be effective

But what happens when someone is not technically trained to perform even the hands-only CPR? The answer is that CPR need not be perfect to be effective. However, one can always learn. When you see a person faint or become unconscious gasping for breath, the first thing is to check the pulse or beating of heart. A person suffering from sudden cardiac arrest will not have detectable pulse, which means he has only seconds to survive. The next step is to call emergency medical service immediately. Almost simultaneously, the person should begin performing CPR and enact the following steps:

• Call out and see if the patient responds
• Look at the breathing
• Feel for the pulse in neck if you know how to, with two fingers
• Place the patient on his/her back.
• Kneel besides the patient on your knees.
• At the centre of the chest, place the heel of your first hand.
• The heel of your second hand should go on the top of the first hand, with fingers of top hand clasping the bottom.
• Start pushing hard and fast with your body weight to put pressure on the chest. Try that the compressions are about two inches deep.
• Deliver 120 to 130 compressions per minute.
• Don’t let go till medical help arrives or you may see clear life signs, such as breathing.

(Dr Vanita Arora is a Chandigarh-based cardiologist)