On 17th March, 2012, Bolton Wanderers player Fabrice Muamba died (technically) for 78 minutes; his heart suddenly stopped beating while on the field of play. It took 48 minutes to get to the London Chest Hospital, where he was revived by an emergency response team. The only reason he survived is that in the 48 minutes before he got to the hospital, cardiopulmonary resuscitation (CPR) was performed on him by, among others, a fan who had come to watch the game.
This is a story with a happy ending, because someone knew how to administer CPR. If it were to occur in your house, could you keep him alive for 48 minutes? Yes, at your house. According to the American Heart Association, about 4 out of 5 cases of cardiac arrests occur at home; so, the next person you may need to perform CPR on may be a very close relative. Knowing to perform CPR is a skill that everyone, medical and non-medical, needs to know.
Cardiopulmonary resuscitation (CPR) is a lifesaving technique performed on someone whose heart has stopped beating or whose breathing has ceased. Many conditions can result in this situation, including, but no limited to, heart attacks, electrocution, injuries and accidents, drug overdose, choking and near drowning. Sometimes, like in the case of Fabrice Muamba, it can happen spontaneously, for no apparent reason.
To fully understand and learn how to perform CPR effectively, one has to undertake a training program, and the following is by no means a substitute for that training. This is to provide enough information so that when one is in dire straits, one can do something that may save a life, rather than do nothing and watch someone die.
The following steps are based on instructions from the American Heart Association, as culled from the U.S National Library of Medicine’s Medline Plus website:
- Check for responsiveness. Shake or tap the person gently. See if the person moves or makes a noise. Shout, “Are you OK?”
- Call emergency services if there is no response. Shout for help and send someone to call 193.
- Carefully place the person on their back on a firm surface (the floor may be used). If there is a chance the person has a spinal injury, two people should move the person to prevent the head and neck from twisting.
- Perform chest compressions:
- Place the heel of one hand on the breastbone — right between the nipples.
- Place the heel of your other hand on top of the first hand.
- Position your body directly over your hands, as shown in the figure.
- Give 30 chest compressions, without bending the elbows. These compressions should be fast and hard. Press down about 2 inches (5 cm) into the chest. Each time, let the chest rise completely. Count the 30 compressions quickly: “1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off.”
The 30 compressions should be delivered within the space of 15 to 18 seconds
- Open the airway. Lift up the chin with two fingers. At the same time, tilt the head by pushing down on the forehead with the other hand.
- Look, listen, and feel for breathing. Place your ear close to the person’s mouth and nose. Watch for chest movement. Feel for breath on your cheek.
- If the person is not breathing or has trouble breathing:
- Cover their mouth tightly with your mouth.
- Pinch the nose closed.
- Keep the chin lifted and head tilted.
- Give 2 rescue breaths. Each breath should take about a second and make the chest rise.
Note: if the mouth cannot be opened or is severely damaged due to injury, the rescue breaths may be given throw the victim’s nose (that is, mouth-to-nose breathing)
- Continue CPR (30 chest compressions followed by 2 breaths, then repeat) until the person recovers or help arrives.
If the person starts breathing again, place them in the recovery position (on the side and slightly facing downwards). Periodically recheck for breathing until help arrives.
Special notes;
- For those who are not competent to go through the entire process of administering CPR, hands-only CPR may be done; this involves chest compressions only. Perform chest compressions (as above) until there are signs of movement or until emergency medical personnel take over. You can keep the timing with the beat of the Bee Gees’ 80’s disco song “Staying Alive”
- For toddlers, do not compress too deeply or blow too hard.
- For babies, use two fingers, not the whole hand, for chest compressions
It is true that after all the effort, only 5 to 10% of people in cardiac arrest will survive after an attempted resuscitation, but it is better to be able to save 5 out of 100, than helplessly watch all die. So, learn to perform CPR, and afterwards, refresh your knowledge regularly. This may help you save a life, and that life may be that of someone you really love.
By: K.T. Nimako (MB ChB)
Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM’s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.
E-mail: [email protected]
Twitter: @KTNimako