Learning CPR may help to save a life

HAVE you ever had to give anyone the kiss of life after they suffered a heart attack?

In the future, you may not need to perform mouth-to-mouth resuscitation after a cardiac arrest, according to new guidelines issued by the Resuscitation Council (UK).

A cardiac arrest is when the normal circulation of the blood stops due to the failure of the heart to contract properly.

The guidelines stress that chest compressions, performed correctly, may help to save the life of a person who suffers a sudden cardiac arrest.

Modern cardio pulmonary resuscitation (CPR) was first practised 50 years ago and currently the Resuscitation Council guidelines undergo a major revision every five years.

Around 270,000 people suffer a heart attack in the UK each year. Just over a third of these (94,000 people) die before reaching hospital, due to a cardiac arrest.

A cardiac arrest is the ultimate medical emergency and the correct treatment must be given immediately if the patient is to have any chance of surviving.

The chain of survival depends upon four key determinants:

::Early recognition of a heart attack and call for paramedic help (to prevent a cardiac arrest).

::Early CPR (to buy time for the paramedics to arrive).

::Early defibrillation with a defibrillator machine (to restart the heart).

::Post-resuscitation care in hospital (to restore the quality of life).

The changes in the basic life support guidelines have been made to reflect the importance of good quality chest compressions and to reduce the pauses during CPR.

The guidelines for an untrained bystander who witnesses someone suddenly collapse and become unconscious are:

::Open their airway, by tilting the head and lifting the chin.

::Check for breathing, by looking, listening and feeling for breaths.

::If they are not breathing, call the emergency number 999 (UK only) or 112 (UK and European Union) and ask for a paramedic ambulance with an automated external defibrillator (AED).

:Start chest compressions immediately in the centre of their chest, using two interlocked hands and straight arms.

::Press down vertically with the heel of your hand about 5-6 cm and give the compressions at a rate of 100-120 per minute.

::Continue chest compressions until the paramedics arrive with a defibrillator.

In cases of a sudden cardiac arrest, the oxygen level in the blood will remain high for a few minutes, so initially chest compressions are more important than rescue breaths.

Pushing down on the centre of the chest squeezes the heart between the chest and the backbone. This forces the blood out of the heart and into the body tissues.

When the pressure is released, blood is sucked in, to be forced out by the next compression. This helps the oxygen in the blood to circulate round the body to the brain and other vital organs.

The heart does not literally stop during cardiac arrest. It gets electrically very active and the only way to get it back into rhythm is with an electrical shock using a defibrillator.

By doing chest compression only resuscitation, a bystander is basically buying time until a paramedic with a defibrillator can jump start the patient’s heart.

If you have been properly trained in CPR however, the advice is still to give a repeating cycle of 30 chest compressions (at the rate of 100 per minute) followed by two quick rescue breaths and continue until help arrives.

A study in the USA combined data from three smaller studies and analysed survival rates in more than 3,700 cardiac arrest patients who received either standard CPR or chest compressions only.

They found that survival improved by 22 per cent when bystanders called 911 (USA only) and were advised by the telephone operator to do compression only CPR. Whether a bystander had previous training in CPR had no effect on patient survival in the study.

I have been a first aider for 25 years and have never had to perform CPR on a person after cardiac arrest. When I first learned what was then called artificial respiration, we spent a lot of time practising listening for breathing and checking for a pulse. We were told not to give chest compressions if we could feel any pulse at all.

The advice has changed dramatically over the last 25 years. Now even an untrained bystander could use an automated external defibrillator using simple instructions.

The device will not shock the heart if it detects a pulse and is safe to use. How things have changed!

If you would like to learn more advanced life support skills then there are several organisations such as St John Ambulance and British Red Cross that offer low-cost emergency first aid courses all over the country.

One of those 270,000 people that suffer a heart attack in the next year could be a member of your family and it might be that the correct emergency first aid could save their life. Be prepared!




Dr Balac is senior lecturer in biology in the School of Applied Sciences, University of Huddersiled