Recently, you may have read about a man who nearly-drowned in one of the famous (now infamous?) Goan beaches. When he was rescued by the salvage team and brought to the shore he was as good as dead. But some by-standers – mostly foreigners – who had been trained in resuscitative techniques managed to keep him alive until he reached the nearest Hospital. A precious life was thus saved! You must have also heard of footballers and athletes dying a sudden death in Goa for lack of a trained resuscitative team.
Today, it is heartening to note, that after medico-legal problems and the “associations” being taken to task, we have, on the spot, competent teams that can start cardio-pulmonary resuscitation in no time. Some of them are even equipped with portable AEDs (automated external defibrillators) which help greatly in the resuscitave efforts. AEDs are used to revive from sudden cardiac arrests which occur due to a disruption in the heart’s electrical activity that causes it to beat dangerously fast (ventricular tachycardia) or irregularly (ventricular fibrillation). Because of this altered heart rhythm (arrhythmia) your heart can’t pump effectively. If you’re having ventricular fibrillation or ventricular tachycardia, and an AED is nearby, a bystander in a public place or a family member at home can attach the self-sticking pads to your chest. The AED then reads your heart rhythm and sends an electrical current to your heart by way of an “electric shock” which can correct the rhythm. If used within minutes, the jolt can restore your heart to a normal rhythm and save your life.
Cardiopulmonary resuscitation (CPR) is an emergency procedure given if the heart stops pumping (cardiac arrest). It combines chest compressions with artificial ventilation in an effort to preserve intact brain function until definitive treatment can stimulate the heart to start working again. If you’re trained in CPR, here’s the way to go: after you’ve performed 12 chest compressions, open the person’s airway using the head-tilt, chin-lift maneuver. Put your palm on the person’s forehead and gently tilt the head back.
Check for normal breathing, taking no more than 10 seconds. Use the heels of both hands and gently but firmly compress the chest near the breast bone. If the person is not breathing, two rescue breaths are given by mouth-to-mouth breathing. Repeat the cycle. Instead of mouth-to-mouth breathing, professional rescuers — such as paramedics — will provide artificial breathing by using a mask with a special hand pump connected to an oxygen tank. Doctors in the emergency department will then put a tube into the person’s windpipe to pump oxygen directly into the lungs.
A general rule of thumb is that brain cells begin to die after approximately 4-6 minutes of no blood-flow. After around 10 minutes, those cells will cease functioning and be effectively dead. Most often the process is initiated by the heart stopping, and this is then followed by brain failure due to lack of oxygen (anoxia). Sometimes it is the breathing that stops first, the lack of oxygen leads to brain failure and later the heart also stops. Bone, tendon, and skin can survive “anoxia” as long as 8 to 12 hours. The brain, however, appears to accumulate ischemic injury faster than any other organ.
Recently the report of a North Carolina man who was revived after the heart stopped for about 40 minutes hit the headlines. The survivor, overjoyed, paid handsome tribute to the emergency workers who brought him back from the dead. John Ogburn, 36, suffered a cardiac arrest while working on his laptop near his Charlotte home last month. Two police officers who happened to be nearby began CPR on this father-of-three within a minute of the 911 call. They took turns resuscitating Ogburn for around 42 minutes (hallelujah!) until his pulse returned.
The lifesaving efforts of these two brave police officers are all the more praiseworthy given that emergency workers are not required to perform CPR after 20 minutes without any vital signs. After Ogburn was brought to hospital, doctors placed him in a medically induced coma to help him recover for the rest of the week. Though he has been advised not to drive for six months and is easing back into work, for the most part, he says he feels completely fine, apart from a sore chest. Ogburn is so overwhelmed that he is still figuring out how to make the most of his second chance at life.
Did you know that sudden cardiac arrest is one of the leading causes of death in the world? Unfortunately, most people who suffer a cardiac arrest outside of a hospital do not get cardiopulmonary resuscitation (CPR) from a bystander. CPR is easy to learn, and if taught to more people more lives will be saved. Those who perform it are held up as beacons of the community and featured in news stories. Proper application of this simple skill could mean the difference between somebody living or dying.
It is often said that a “dying love” to be revived needs CPR (caring, passion, romance). So also a dying man to be resuscitated needs CPR (cardio-pulmonary-resuscitation). A little effort can yield rich dividends.
(Dr. Francisco Colaço is a seniormost consulting physician, pioneer of Echocardiography in Goa.)
