did you ever stop to think about how?

One of the recommendations one hears in CPR class sessions is "Get the victim on their back on a hard, flat surface."

Recognizing that two thirds of all arrests in the U.S.A. occur in the home, you are going to fit into one of the categories below.

1. I can physically pick up my spouse and place him or her on his or her back on a hard, flat surface, and my spouse can do the same for me.
2. I am the only adult in my home.
3. One of us can pick up the other and get him or her onto his or her back on a hard, flat surface.
4. Neither one of us can do that.

OK. Those of you who fell into group 1 or 2 can skip the rest of this. Those who are in groups 3 or 4 really need to watch www.slicc.org/2014CV_AdultCPR.mov. I can painfully testify that my 113 pound wife can get my 185 pound body out of a recliner or out of a bed and onto the floor without a problem.

If you are interested in the entire video, go to www.slicc.org and click on "For past trainees" in the left column. The Intro and the Adult CPR segments are the only 2014 videos, but the entire 2012 video is up there, as well. SLICC's instructional videos assume that you will be a "lone rescuer."

Here's a tip that can save someone's life...

How many things can you think of that you did better the first time you did them than the second?

Not a lot, right?

Here's the point: You have a rediculously high chance of seeing someone you know have a cardiac arrest, and getting it right the first time is important.

So you and your spouse need to take turns pretending that the other just had a cardiac arrest and acting out what you would do.

What would you do?

Hopefully, you would...

1. Determine that it's safe to help - there's no high voltage power line on top of the person, right?
2. Check to see that the person is truly unresponsive and not breathing normally.
3. Call 911 while walking to the door to unlock it. 
4. And don't let 911 hijack the call - and tell them (a) where you are, (b) what's wrong, (c) what you are doing about it, and (d) what you need. If you don't take charge of the call, they will keep you on the phone longer than you can afford to ignore the victim.
5. Get the victim on their back on a hard, flat surface and start chest compressions - at least two inches deep, and at least at a rate of 100 - 120 per minute.
6. Don't even think of breathing for that adult - they won't need it for the first 5-10 minutes, and interrupting the compressions, really reduces their chance of surviving.

It will be soooo much easier to get it right if you have practiced. Seriously.

See www.slicc.org if you have questions.

Best,

Bob

What is the most likely place you will see an arrest? ...and what can you do?

More than 2/3 of all cardiac arrests occur in the home.

When that happens, you might have to get the victim out of bed - or out of the recliner - onto the floor. You then need to roll the victim onto their back and begin CPR.

We need to get the American Heart Association and the American Red Cross to change their curriculum to teach what is actually needed to perform CPR on the victim of a cardiac arrest.

The most effective way to get someone out of bed is to throw the covers off the foot of the bed, untuck the bottom sheet from the far side and throw it over the victim, and pull the bottom sheet until the victim rolls out of bed. Hopefully you have placed a pillow on the floor where the head is going to hit. See www.slicc.org click on For past trainees in the left column, and watch the "Adult CPR" video.

The most effective way to get a victim out of a recliner is to reach across the victim and pull that distant arm over the body to roll them out of the recliner.  See www.slicc.org click on For past trainees in the left column, and watch the "Adult CPR" video.

There's an observation I make at the end of every Bystander CPR class that always gets a "startled look" response from the attendees. I tell them "Keep in mind that, now that you know CPR, you are no safer than you were before. It's the people you hang out with who are safer!"

Then I tell them to make a list of the people they hang out with and invite them over for a beer. When they get there, tell them you were just kidding about the beer - they are there to watch our class video and learn how to save each other, should they have a cardiac arrest or a stroke. (The class video is a free download. Go to www.slicc.org and click on "For past trainees" in the left-hand column. It's currently in transition from the 2012 complete class video to the 2014 class video, and not all the 2014 modules are up yet. Watch the 2014 modules first and then fast-forward through those sections of the 2012 video.)

Teach your friends using our materials - it will re-enforce your understanding and will get you into a safer environment.

OK, Teammates. Here's how it all sorts out:

First, if you see a person have a cardiac arrest and you are in an ambulance or in the Emergency Department, you already know what you need to do.

BUT, if you are in a situation where when you see someone arrest, you need to call for an ambulance - and I don't care whether you are a doctor, a nurse, a paramedic, or an EMT - the odds of your being able to perform Guideline-Compliant Chest Compressions ("GC3's") from the time of the arrest until the ambulance crew is "hands on" at the victim are slim-to-none.

First of all, we have studied chest compression stamina and chest compression depth, and I can assure you that you are an exception, if you are able to perform GC3's until the ambulance crew takes over, when you are using what we teach in a normal CPR class.

The things we teach in a normal certification class don't address the very real problem of getting the victim onto the hard, flat surface we talk about, and it ignores the fact that you might not be able to get down onto the floor, you might not be able to use your hands to compress the chest, the chest might just be too stiff for you to compress, or you might just already be too tired.

The solution SLICC is proposing is to use your foot, not your hands.

Check the Adult CPR portion of SLICC's 2014 Class video:
http://www.slicc.org/2014CV_AdultCPR.mov

...and make sure the people you spend a lot of time with watch it, too. You cannot pump your own chest.

Best wishes.

Bob

A different way of thinking about CPR

The American Heart Association teaches two types of CPR. For healthcare professionals, the BLS (Basic Life Support) class is required. For Bystanders, continuous chest compressions are taught for adults.

Understandably, a natural split has evolved along the lines of professional credentials: if you hold professional medical credentials, you perform BLS skills. If you do not, you perform what is taught in the bystander courses. But this may not be best for the victim.

A different way of deciding what to do when you witness an adult arrest is to ask yourself, "Am I going to have to call 911?" because if you are, then (1) you are not in a hospital or on an ambulance, and (2) you probably aren't going to be able to perform Guideline-Compliant Chest Compressions ("GC3's") from the time of the arrest until the "hands-on" arrival of the ambulance crew.

What I am proposing that you consider in this circumstance is performing continuous chest compressions with the heel of your foot (pedal compressions) whether or not you have BLS training.

This way of deciding what to do will lead to some non-traditional approaches. For example, arrests in doctor's offices, dentist's offices, local "immediate care" outposts of hospitals, while all places where one would expect to find BLS-trained people, they would initially be performing continuous chest compressions, and if short-staffed, might have to switch to pedal compressions to maintain GC3's until the ambulance crew was "hands-on" at the victim.

For further information, see the case for pedal chest compressions.

(Of course, if the victim has arrested secondary to choking or if the victim is a child or if the victim has begun to exhibit signs of a depleted oxygen supply and you have BLS skills, they would be more appropriate.)

Bob Trenkamp, President
Saving Lives In Chatham County

I love not being needed!

I also serve as a Medical First Responder in the community where I live. 

Last week I was toned out to respond to a local church where a person had passed out.

By the time I got there, two people in attendance at the church had determined non-responsiveness, called 911, determined non-normal breathing, begun CPR, retrieved the AED, applied it, and had a living, breathing Cardiac Arrest Survivor on their hands. The victim was transported and now has a pacemaker.

That, my friends, is how we solve the problem of too many dying form SCA's: Available AEDs and people who know how to recognize a Sudden Cardiac Arrest when it happens and what to do!

It's nice not being needed!

Bob