The life of the party? CPR is an ideal guest
The life of the party? CPR is an ideal guest
I threw a dinner party and almost killed one of my guests.
One minute we were eating and talking, the next minute someone was choking, unable to breathe, and all I could do was sit there frozen. I had no idea what to do.
Thank goodness, one man did. He quickly performed the Heimlich maneuver, and the guest’s life was saved.
Everyone was grateful and hugely relieved, of course, but I couldn’t help thinking how abysmally useless I had been. How could I not know a basic lifesaving skill?
It turns out that I’m typical of many Americans who don’t know the simple ways a bystander can save another person’s life.
Obviously, calling 911 is the first thing to do – something else my stunned self didn’t remember, although someone else did – because often the dispatcher can coach you through what’s needed before professional help arrives.
But sometimes that’s not possible or easy and, unfortunately, time is of the essence: Brain cells start to die after less than five minutes without oxygen, which can cause permanent brain damage.
The American Heart Association and some hospitals are pushing to make lifesaving techniques easier and more convenient to learn. Choking kills about 5,000 Americans annually, while about 450,000 Americans die of cardiac arrest, mostly at home, work or in public rather than at a hospital. For both types of emergency, bystander help can be the difference between life and death.
Since my dinner-party crisis, I’ve made it a point to get trained, and it’s really not that hard: For a person who is conscious but choking, the simplest and most effective action is the Heimlich maneuver, a series of abdominal thrusts invented by thoracic surgeon Henry Heimlich. Here’s what you do:
– From behind, wrap your arms around the person’s waist.
– Make a fist and place the thumb side in the middle of the victim’s abdomen, just above the navel.
– Grasp your fist with your other hand, press hard into the abdomen and give a quick upward thrust into the upper abdomen, as if you were trying to lift the person. Repeat until object is expelled.
The American Red Cross recommends first bending the person over and giving them five back blows with the heel of the hand followed by five abdominal thrusts, but Heimlich vehemently disagreed with that advice, and other experts, such as the heart association, say back blows can be skipped.
For a person who starts choking and then loses consciousness, however, CPR must be started, which bring us to another lifesaving technique that not enough Americans know.
“Fewer than 1 in 5 Americans has current hands-only CPR training. It should be right up there with learning to swim – a basic skill everyone should know,” said emergency medicine physician Benjamin Abella with the Center for Resuscitation Science at the University of Pennsylvania.
In the case of cardiac arrest because of choking or because a malfunction in the heart’s electrical activity leads the heart to stop abruptly, it is most often CPR from a bystander that saves the person’s life, he said. And yet less than 3 percent of Americans receive CPR training annually, leaving many bystanders unprepared to respond, according to a 2015 Institute of Medicine report that urged hands-only CPR training be made a national priority.
“Without treatment within 10 minutes, the survival rate (for cardiac arrest) is almost zero,” the panel of experts wrote.
More troubling are American Heart Association statistics that show three times as many Americans avoided performing CPR to save someone’s life last year despite knowing how. The association’s survey of nearly 1,200 adults trained in CPR found that 13 percent had the opportunity to perform CPR in 2016 but didn’t; in 2014, it was only 4 percent. Respondents said fear of legal ramifications and harming the person were the top reasons for their hesitation, even though good Samaritan laws generally protect a person from getting sued if they were acting in good faith to save someone’s life.
The rate of up-to-date CPR training remains low, especially among older Americans, according to a new study by Abella and a team of researchers. The study, published in the Journal of the American Heart Association, found that those older than 60 were about 50 percent less likely to be trained in CPR compared with those 49 and younger.
“It’s a double threat. People in their 60s and 70s are more likely to have cardiac arrest and less likely to be trained,” Abella said.
And while more young adults are learning CPR, thanks to a growing number of states that make it mandatory in high school, “I worry about a 65-year-old spouse having cardiac arrest at home with a similarly aged spouse who doesn’t know CPR,” he added.
“The lack of people knowing hands-only CPR has frustrated me my entire professional career,” said cardiologist Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital. “Needless lives are lost, and it’s so simple. Thirty seconds and we can show you what to do.”
Her frustration is personal: Her older brother died of cardiac arrest seven years ago at age 50, shortly after returning home from coaching his son’s soccer game.
And while older adults are more at risk, it can happen to younger people, including kids playing sports. “But they can be saved if we get people to act,” Andersen said. “They don’t need to go to a class or get certified. Our videos stress how using your hands can save a life.”
Simple hands-only CPR involves basically two steps:
Call 911 (or tell someone to do it for you).
Place one hand over the other and place them on the person’s chest, between the nipples. Use your upper body weight to push hard, without stopping, for 100 compressions per minute until help arrives. (You can pace yourself by doing it to the rhythm of the Bee Gees’ “Stayin’ Alive”).
To stress how easy it is to learn, New York-Presbyterian has been promoting its 30-second “Everyone Can Save a Life” video on social media and online, along with a 40-song playlist of memorable songs at the perfect 100 beats a minute. (The hospital uses “Stayin’ Alive” to train first responders, but the playlist also includes songs by Justin Timberlake, Lady Gaga, Beyoncé and others.)
Showing hands-only CPR videos at Mets Stadium and Times Square is in the works, Andersen said, and she’s talking to some airlines about showing the video to their passengers. A European cardiology task force proposed new guidelines to train airline personnel in how to treat such emergencies, following the death of actress Carrie Fisher last year after suffering cardiac arrest on a flight to Los Angeles.
Andersen and Abella worry that too few Americans realize that mouth-to-mouth resuscitation is no longer necessary for CPR on adults, thanks to a change in guidelines in 2008. That could be one reason Americans hesitate about getting trained.
“It’s a question I get all the time. People are worried about whether they need to do the breaths,” said Manny Medina, a CPR instructor with the American Heart Association in San Diego.
The other common worries he hears from people: “That they’ll hurt the person, maybe crack a rib from pressing on their chest. And that they’ll get sued.”
Medina reassures them that no mouth-to-mouth is required, just the hands-only technique. In fact, what’s most important in reducing cardiac arrest deaths is starting those compressions as soon as possible. Doing something is better than doing nothing, he tells them.
“And I tell them that a person would rather wake up with a cracked rib from someone performing CPR than to never wake up again.”
(c) 2017, The Washington Post.
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