Simple Skills Save Lives! – Cardiac Arrest and CPR

Welcome to lesson one in our saving lives series. In this session you will learn what a cardiac arrest is; how to identify when someone has suffered from a cardiac arrest, and what to do.

Cardiac Arrest – Different Heart Rhythms

Have you ever wondered what you would do if you came across a person who has collapsed in the street? One of the most common responses I hear to that question is that “I wouldn’t be much help” or “I couldn’t do anything to help.” The thing is that helping may be easier than you think, and with a few simple skills you could save a life.

According to the British Heart foundation there are more than 30,000 out of hospital cardiac arrests in the UK each year, with a survival rate of just 1 in 10, but what exactly is a cardiac arrest?

Often confused with a heart attack, a cardiac arrest is an electrical problem affecting the way that the heart beats, as opposed to a heart attack, which is a plumbing problem in which one of the arteries supplying blood to the heart becomes blocked.

In a cardiac arrest the electrical impulses which cause the heart to contract and pump blood around the body become scrambled, causing random contractions of the heart muscle. When this occurs the heart can no longer pump blood effectively, and the organs of the body become starved of the vital oxygen and nutrients required to survive. Without intervention, this scrambled heart rhythm will continue to get worse until the heart eventually stops beating altogether.

When somebody suffers from a cardiac arrest, time is vital. The longer they are left untreated, the smaller their chance of survival becomes. The first step is to identify that a cardiac arrest has occurred, and we do this by following a simple process known as DR ABC.

DANGER – First and foremost we need to make sure that it is safe to approach them. Rushing into a situation without knowing the circumstances is a risky strategy that may lead to you yourself becoming another casualty, making the situation twice as bad as it was in the first place. You can’t help them if you need help yourself.

RESPONSE – Call out to them; ask them to open their eyes if they can hear you. If they respond to this by opening their eyes then we can rule out a cardiac arrest for the time being. If you get no response then we move onto the next part.

KEY POINT: Call for help. It is all too easy to start helping the casualty and forget to call for an ambulance. You should do this as soon as possible.

AIRWAY – We now need to open the casualty’s airway to find out if they are breathing. We do this by placing our fingers under the bony part of the chin and the other hand on their forehead. Gently tilt back the head and place your cheek next to their mouth.

Opening the Airway – head tilt chin lift

BREATHING – We will now look, listen, and feel to see if they are breathing.

Look at their chest to see if it is rising and falling; Feel for their breath on your cheek and Listen to see if you can hear them breathing.

Do this for 10 seconds. You need to identify at least two breaths in ten seconds. If they only breathe once, or they are just gasping occasionally then they are not breathing effectively.

CALL FOR HELP/CPR – If you have not already called 999 then you should do so immediately, stating your location clearly, and that the casualty is not breathing. The call handler will stay on the line and talk you through the next steps. It may be easier where possible to put them on speaker phone so that you have both hands free for CPR.

How do I carry out CPR?

In order to carry out CPR the casualty needs to be lying on their back on a solid surface. Soft surfaces such as beds of sofas will flex when you are compressing the chest, reducing the effectiveness of the compressions.

We start with thirty chest compressions. To carry out chest compressions kneel beside the casualty and place the palm of one of your hands on the centre of the chest on the breastbone (Sternum). Place your other hand on top and interlock your fingers.  

CPR – Hand Position

Lock your elbows and position yourself so that your shoulders are directly above your hands and your arms are straight. Using your body weight compress the chest by between 5 and 6 centimetres, and then release again, ensuring that you fully release. That is one chest compression, and you need to repeat this 30 times at a rate of between 100 and 120 per minute, that’s around two per second. To get the rate right it can help to sing nelly the elephant or stayin’ alive by the Bee Gees (preferably in your head of course).  

Following 30 compressions we then attempt to carry out 2 rescue breaths. To do this we need to open their airway, just as we did before checking for breathing, pinch the casualty’s nose to close the nostrils and cover their mouth with ours. Breathe into their mouth as if you are breathing out normally. You are not trying to blow up a balloon, and if you blow too hard then you will probably end up filling the stomach with air, which may in turn cause the casualty to vomit. If the casualty does vomit simply roll them onto their side and allow this to drain from their mouth before continuing.

Rescue Breaths

If the two breaths are not effective, don’t waste time trying two more. It is vitally important that we get straight back on the chest and carry out the next set of chest compressions. You should only stop CPR if someone else arrives to take over; a medical professional arrives and either takes over or asks you to stop; you become too exhausted to carry on, or the casualty recovers, which is extremely rare when carrying out CPR alone.

In lesson two we will look at the recovery position, and how to use a defibrillator…

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