June 4, 2012

Safer Streets 2012 and CPR Week

What you should know about CPR

CPR saves lives. CPR should be a standard skill of all persons.

I have heard some medical professionals say to me over the years that CPR is not as it is vaunted. My experience differs and I conclude that CPR does save lives.

One of my best examples is in the Cardiac Catheterization Lab in most hospitals. In the cath lab, cardiac arrest is fairly common. Patients sometimes react to the contrast medium by a cardiac standstill. All health care professionals know CPR and they know how to recognize the cardiac arrest situation. All they do is run a quick Code Blue – all that’s needed is a moment or so – and the patient recovers. It is common. CPR works.

This is because the heart is a pump, and it can be operated manually.

In the cath lab, the patient is observed, the standstill is witnessed, even anticipated, and providers are able to act immediately. CPR works. It works because of the immediacy of the personnel. Immediacy on the street or other out-of-hospital location is the key there, too.

The issue for some laymen, however, has been that CPR doesn’t work. Some have said to me that it doesn’t always work. Mechanically, as in the cardiac cath lab, it certainly does work. It works in the field, too, when it is delivered and when the overall health and condition of the patient favor it. As I have written over the last decade, CPR is not for the dead and dying, it is for the viable, which brings me to why I encourage learning CPR and First -aid.

CPR is integral to the mission of EMS worldwide, and that mission is to prevent premature death and disability due to acute illness or injury. The emphasis is on premature. The CPR training of the bystander or Good Samaritan is identical to that of the professional, and their impromptu mission is the same: to fight premature death.

The immediacy in the field is that the bystander is and always has been the original first responder, and long before President Bush coined the term shortly after 9/11. In my day, we were called Paramedics or EMS. First Responder as a term did not exist thirty years ago. More than four decades ago, before anyone even heard of EMS, the movement to train millions of laymen came alive, and today, more than 20 million Americans know CPR or know of CPR well enough to save a life.

One of the more compelling things you might like to know about Citizen CPR is that it isn’t only for heart attacks. This is where the saves come in by way of bystanders even before EMS can arrive. This is where one can see that CPR works.

When EMS strives to prevent premature death, it spans all age groups and it spans all emergencies. As a trained citizen bystander, you would be able to do the first critical concept, and that is to recognize a non-breathing condition. It could be, for instance, a pre-teen who has fallen from a horse. As a trained laymen, you may be able to discern the cardiac arrest and deliver CPR to a 40 year-old man at the airport. As a trained person, you can see the 20 year-old man brought unconscious out of the ocean at the beach. CPR is not just for heart attacks, and it is not merely for the aged. It is to fight premature death. It is your immediate action which fights premature death.

The purpose of training likely bystanders by the millions is that the Automatic Defibrillators at the airports are not always visible and easily accessible. Lifeguard stations at the beach may be closed for the season, or Lifeguards otherwise unavailable. The entire purpose of Citizen CPR is that someone is there in the absence of professionals, someone who can act until they arrive. Response times at an airport, a ranch, or at the beach, workplace or amusement park may be extended such that only you are their lifeline. Only you.

UCLA’s Center for Pre-hospital Care has announced CPR Week for June 1- 7, 2012 and encourages citizen training in CPR. UCLA’s event offers free hands-only training June 7th from 9 am till Noon at UCLA Bruin Plaza. Is there a CPR Week Fair in your neighborhood? CPR Instructors around the country can certainly announce and hold their own booth at a variety of venues and elaborate the community benefits of a greater concentration of trained persons within their neighborhood or workplace. I recommend one out of ten persons in a workplace be trained in CPR.

UCLA points out some important figures, among them the finding that only 32% of cardiac arrest victims get CPR from a bystander. Bystander CPR is critical to the safety of the patient prior to the arrival of Advanced Life Support.

Finally, I want you to think of outcomes. The patient’s ultimate outcome is not determined by the Squad entirely, because the clock has started from the second of onset of the emergency. The patient’s ultimate outcome is determined by immediate intervention, often from a bystander, often within seconds, and throughout the long minutes before the arrival of EMS.

Patient outcomes often mean that families can have their loved ones back, family members of any age, of nearly any possible emergency. Not only does care begin the moment you begin, but Hope begins precisely at that moment, too.

Learn CPR and First-aid.

The life you save may never thank you, but you will know you made all the difference in their world.

John Longenecker graduated UCLA’s Daniel Freeman Paramedic School in 1977. He is author of The CPR Corollary – a monograph on how the armed citizen and the CPR-trained mean smaller government in 2012.

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