Whether it’s a stranger going into cardiac arrest in a localmall or a larger scale tragedy like the recent bombings atthe 2013 Boston Marathon
, first response to those in need can be a matterof life and death.
The American Heart Association says that “70percent of Americans may feel helpless to act during a cardiac emergencybecause they either do not know how to administer CPR or their training hassignificantly lapsed.” To no longer be part of that 70 percent, I attended a freecardiopulmonary resuscitation (CPR) training course taught by the Hospital ofthe University of Pennsylvania(HUP) Nursing Community Outreach Program to West Philadelphia residentsat New Bethlehem Baptist Church. Thecourse is one of many efforts by Penn Medicine nurses to volunteer their timeand talent in the community.
“HeartDisease is the number one cause of death in this community,” said Pam Mack-Brooks, MSN, CRNP
, director ofthe HUP Nursing Community Outreach Program. “The nurses felt that to equip evenone member of a family would be a powerful step to helping save a life!”
I also attended Philadelphia Science Festival’sDiscovery Day in Clark Park where DavidBuckler from the Center forResuscitation Science and Penn Presbyterian Medical Center (PPMC) nurses Laura Solano, MSN, RN, CNS and James Kurtz, RN, offered hands-ontraining in Hands-only CPR to kids and adults.
Below are some questions I had before attending thesesessions in hopes that it will assist some of you who are unfamiliar:
When is CPR needed?
If you suspect that someone may need CPR, first ask them if theyare okay. If they do not respond, call 911 immediately and begin CPR.
Patricia Toth, MSN, RN, nursing professional development specialist at HUP, explainedto CPR course attendees that CPR should be done only when someone isunconscious or unresponsive. Thismay be due to several causes of cardiac arrest.
The instructors added that somepeople do not do CPR because they are afraid of hurting the person involved;but reaffirmed the point that action is needed as the person might dieotherwise.
How do I perform CPR?
The approach for an adult,child,and infantare all different.
Basically, after (or during if on speakerphone) calling 911,pump hard and fast on the chest for at least 100 compressions per minute (actuallyto the same beat as the BeeGees’ Stayin’ Alive), and at least two inches deep, to pump blood to theheart and brain until paramedics arrive. Only if you know the person, should those compressions be preceded bytwo breaths in mouth-to-mouth resuscitation. Lay people are encouraged to do hands-only CPRwithout breaths for adults who suddenly collapse and whose case is not due todrowning. This is due to the importance of compressions and the fact thateffectively delivering breaths is difficult for novices and may take valuabletime away from delivering compressions.
All Penn Medicine hospitals are now implementing afour-year, CPRHospital-Initiated Training Project, started in 2010 and led by PrincipalInvestigator Benjamin Abella, MD, MPhil,and Project Manager Audrey Blewer, MPH.The project has been championed at PPMC by floor nurses such as Jim Kurtz, RN who provides CPR trainingto family members of inpatients at high risk for cardiac arrest. Theinitiative provides CPR training to these families and gives them a “CPRAnytime Kit” to practice their CPR skills and share with others.
“This past year, we have trained over 670 family members of“at risk” patients at eight area hospitals (including UPHS facilities),” saidBlewer. “Since two-thirds of out
of hospitalcardiac arrests occur in the home, CHIP (the hospital-based CPR training model)equips the “high risk” population with the life-saving skills of CPR.”
Using the American Heart Association’s CPR Anytime video removesthe need for a certified instructor and allows individuals to learn CPR in lessthan 25 minutes. Those individuals are then encouraged to take the CPR Anytimekit home to share the skill with other friends and family. Currently in thesecond year of a four year study, the team hopes to train 2,000 people anddevelop a sustainable program that can be disseminated through hospitalsnationally.
When do I use an AutomaticExternal Defibrillator (AED)?
Knowing where to find an AEDisn’t always easy, as many Philadelphians discovered while participating inPenn Medicine’s MyHeartMapChallenge. If you suspect thatsomeone is going into cardiac arrest, take the two pads of the AED and placethem on the individual across their heart, turn it on and press the analyzebutton. The device will prompt you with further instructions if the individualneeds a shock.
Where can I receivethis training?
The Red Cross provides hands-on first aid and CPR courses.To sign up, visit redcross.org/takeaclassor call 1-800-REDCROSS. The Red Cross also offers a free iPhone and Android appwith useful first aid information preloaded even if the user does not haveinternet connectivity.
This post is a very brief overview and certainly does notsubstitute for actual training. While we all hope to never need these skills, everyonereading this should take the opportunity to develop them, and if called upon,know how to save a life. Remember, if thisbaby is trying to do it, you should also.
Back row left:
Pam Mack-Brooks, Pauline Ansine, Monica Harmon
Theresa David, Susan Cobb, Pat Smith, Victoria Brown, Tina Cooper, Dotti Grochowski
Eula Davis, Patti Toth