• Shrikanth Venugopalan

All the people above 12 should be taught CPR

Introduction

Cardiopulmonary resuscitation (CPR) is the supportive and specific treatment given immediately to patients in which, for some reason, the cardiac and/or ventilatory activities have stopped. It is a lifesaving technique that's useful in many emergencies, such as a heart attack or near drowning, and is known only to less than 2 percent of India’s population.

CPR Day is observed on July 27. CPR is the manual application of chest compressions and ventilation to patients in cardiac arrest, done in an effort to maintain viability until advanced help arrives. This procedure is an essential component of basic life support (BLS).


Every problem that we have is a problem at scale

Among India’s population, less than two percent of the population are aware of CPR. Every year, approximately 4,280 people per 100,000 people in the country suffer from cardiac arrest. Every minute, 112 people succumb to cardiac arrest. This is a very big problem. CPR is an issue in India because the general public has never been trained in CPR.

We do not have a robust emergency medical system, and ambulances can’t reach people in the first three minutes, when CPR can be life-saving. Remember when former President APJ Abdul Kalam suddenly collapsed at IIM Shillong, and nobody could do CPR? This makes learning about CPR all the more important.


Demographics

If we talk about data, then almost 80 to 82 percent of cardiac arrests happen outside hospitals. The chances of survival decrease by 10% every minute. If we don’t immediately give CPR, the patient will have a brain injury. It has been discovered that with increased CPR practice, 40–60% of people can be saved. Since time is important, any layman can manually start a heart with a skill that can be learned with practice in 5–10 minutes and can save a life. The Indian Medical Association (IMA) is trying to create awareness, mainly among auto and bus drivers and police personnel.


CPR is mainly given to provide adequate pulmonary ventilation and to facilitate the pumping of the heart so that effective circulation can be maintained. It comprises three basic rules: ABC: A for airway, B for breathing, and C for circulation. All these can be maintained by effective chest compressions. CPR has 2 components: pulmonary resuscitation and cardiac resuscitation.

The Different Methods

Pulmonary resuscitation is of 2 types: manual and mechanical. Mechanical methods and cardiac resuscitation are mostly performed in hospitals with various instruments and under professional supervision. The manual methods are less effective than the mechanical methods but are more useful because they are easy to perform, do not require any equipment, and can be used as a first aid method until further medical services are available. There are four manual methods: mouth to mouth, the Holger Nielsen method, the Sylvester Broche method, and the Schafer method.

Mouth to Mouth Method

The mouth-to-mouth method involves laying the patient on his or her back in a supine position. Tight clothing, such as tight collars, is to be removed. Visible mucus, vomitus, and debris from the mouth are removed. The head is tilted backwards and the chin is lifted upwards, which extends the neck and opens the airway. Open the patient’s mouth and close the nostrils. Take a deep breath and forcefully exhale into the patient’s mouth. Maintain a rate of 10 to 12 breaths per minute and observe for chest expansion and gastric distension.

Holger-Nielsen method

The Holger-Nielsen method involves lying the patient on his or her stomach in a prone position. The head is rested sideways on the arms and elbows. Kneel down near the patient’s head. Raise the subject’s hands just until resistance is felt. During this maneuver, the thorax expands and inspiration takes place. The patient’s arms are gently dropped. During this maneuver, expiration takes place. The whole cycle is repeated 10–12 times per minute. This method is mostly used in cases of drowning.


Sylvester Broche method

The Sylvester Broche method involves lying the patient on his or her back in a supine position. Kneel before the patient’s head. The patient’s hands are taken, interlocked, and placed on the chest. Perform 1 to 3 chest compressions. Then extend the arms all the way to the back until resistance is felt. Reapply the hands to the chest and repeat the cycle 10–12 times per minute.This method is mostly used in cases of electrocution.

Schafer’s method

Schafer’s method involves lying the patient on his or her stomach in a prone position, with the head resting sideways on the arms. Kneel between the legs of the patient and place your hands in a W-shaped position on the lower back. Press for 3 seconds and release for 2 seconds. Perform this cycle 10–12 times per minute. This method is mostly used in cases of drowning.



Real Life Incidents

Now that we know what CPR is and what its types are, the real issue is: why do kids not know this? There are numerous cases of kids using CPR. For example, a 13 year old boy in Arizona saved the life of his baseball coach by performing CPR. Studies also show that kids as young as 9 years old can and should learn CPR.

Previous studies have questioned whether it is worth teaching school children CPR and other life-saving skills because they may not be strong enough or able to retain the knowledge effectively. Even if physical strength may limit CPR effectiveness, cognitive skills are independent of age, and with periodic retraining, children’s performance would likely improve over time.

Though training and skills should be updated and refreshed every two years, those skills will stay with the child for life. You never know when someone might come across a terrible car accident or emergency that will put their CPR skills to the test.


Conclusion

When a loved one experiences a cardiac arrest, seconds matter. A cardiac arrest can occur at any time and anywhere - home, work, or play, and the victim could be anyone, even someone you know and love. The steps to saving a life are simple, and I believe everyone should learn them.

 

Shrikanth Venugopalan