Self help: CPR for dummies

Published July 11, 2010

What happened to me can happen to anyone A tiny little piece of a potato chip went down my windpipe and got stuck. I coughed hard in an effort to dislodge it, but the chip remained there adamantly. My chest heaved, and within a few seconds I felt as if my chest would explode. I tried to scream to tell my friends I was choking, but I couldn't even manage an eek. My eyes flooded with tears as I felt this sudden terrifying feeling of utter helplessness, for there is nothing more horrific than being unable to breathe.

My friends, still unaware of my predicament, went on with life as I sat there feeling I was going to die. But still gasping for breath, I managed to grapple the shoulder of a friend and shook it with all the little energy I had left. The casual chattering was instantly replaced with panic. Time seemed to have stopped. There was only stress and alarm. Someone started patting and rubbing my back. Someone else brought me water. I was asked to look towards the sky. I did what I could.

But the blocking chip was finally dislodged because someone performed CPR on me and the ordeal ended within a few seconds. A simple case of choking had caught us off-guard that day. But it could have been worse — even fatal.

I came across cardiopulmonary resuscitation, or CPR, while attending a training course in Basic Life Saving Skills at a local medical university in Karachi. It made me realise how a small and simple procedure could have prevented the panic and provided quick relief.

The widely-practised and advised procedure takes only a few hours of training and is universally standardised. The great thing is that such courses are now being conducted in various urban areas of the country and many medical students and others from various walks of life are being provided training on a regular basis, however, the numbers aren't enough.

During the course, I learnt that while responding to choking, like I had experienced in the company of my friends, one should get the victim's attention and assure them of help. Once this has been done, one should lock the arms between the patient's navel and diaphragm and exert an upward push to dislodge the blocking object. The procedure should be practised well, so that one can do it right when the need arises. In case the patient becomes unconscious, a call for help should be made to emergency medical services immediately, while the attendant should start CPR.

The procedure was designed by the American Hearth Association 50 years ago, and initially conducted to acquaint physicians with close-chest cardiac resuscitation. The American Heart Association advocates bystander CPR in public awareness campaigns and recommends state-subsidised refresher courses offered by first-aid professionals all over the world. The decision to perform, or not to perform rescue-breathing should depend on the bystander on site and should not be dictated by official resuscitation guidelines.

A patient suffering cardiac arrest has very little chance of survival unless a bystander takes immediate action to sustain them until the paramedics arrive. Eighty per cent of all out-of-hospital cardiac arrests occur in private residential settings. Being trained to perform cardiopulmonary resuscitation (CPR) can mean the difference between life and death. Effective bystander CPR, provided immediately after cardiac arrest, can double a victim's chance of survival.

Studies reveal that 95 per cent sudden-cardiac-arrest victims die on the way to the hospital. These deaths, though inevitable, could be reduced if more people knew CPR. Brain death resulting from lack of blood flow to the command centre starts to occur four to six minutes after someone undergoes cardiac arrest. Chest compression even without rescue breathing ensures necessary circulation of the blood and prevents damage to the brain.

In the absence of CPR, chances of survival for such victims decrease by seven to 10 per cent for each minute's delay, if a bystander CPR is not provided. Few attempts at resuscitation are successful if CPR and defibrillation are not provided within minutes of collapse.

Currently only a number of centres are providing good quality training courses in CPR which are open for all those interested in acquiring this basic life saving skill. However, there is a dire need of taking this programme to various other institutions and faculties other than just medical and health sciences.

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