IMMEDIATE bystander CPR and early activation of emergency services are crucial when it comes to saving the life of a patient who has experienced a cardiac arrest.
Faheem Essop, an Intermediate Life Support (ILS) practitioner at ER24 knows all about this. He had to do what he knew well at a recent motor vehicle collision - save lives under unforeseen circumstances. The only difference was it was not the driver who needed immediate help.
“My partner Dean and I were dispatched to a single motor vehicle collision in Johannesburg about a month ago. On arrival, two men, who were on scene, had an altercation. We assisted the driver of the vehicle who had only sustained minor injuries. As we assessed him in the back of the ambulance I heard a loud noise against it.
“I thought someone must have driven into us or something. As I got out of the ambulance I saw the one guy, of the earlier altercation, clutching at his chest. I suspect he had a myocardial infarction. As I knew my partner was busy with the other patient I immediately sprang into action.
“He was found to have a shockable rhythm, so I defibrillated him and immediately continued with CPR. We requested an advanced life support paramedic and while waiting I continued with CPR and defibrillation until we felt a pulse. We then rushed him to Charlotte Maxeke Johannesburg Academic Hospital.
“If we weren’t there at that specific moment he probably wouldn’t have survived. There was no pulse and he didn’t breathe for quite a while. When we arrived at the hospital the doctor said that the immediate CPR had been a tremendous help to this man.
“I truly believe effective CPR can make a big difference. When you see a life-threatening rhythm on the monitor it is quite an amazing feeling when you get the patient’s pulse back,” said Faheem.
Dr Robyn Holgate, ER24’s Chief Medical Officer, explains why effective CPR is of utmost importance when a patient is in cardiac arrest.
“Cardiac arrest is synonymous with clinical death. Early CPR improves the flow of blood and oxygen to vital organs, an essential component of treating cardiac arrest. The earlier you give CPR to somebody in cardiac arrest, the greater their chance of survival. CPR should be started as soon as possible and interrupted as little as possible.
“The component of CPR which seems to make the greatest difference is chest compressions. Once chest compressions have commenced don’t forget to place an AED on the patient’s chest if there is one available. This will help to analyse and identify a shockable rhythm. Early defibrillation - with an AED, or defibrillator as soon as the EMS arrives within the first few minutes of cardiac arrest - is the only effective treatment in the management of ventricular fibrillation.
“If defibrillation is delayed, the rhythm is likely to degenerate into asystole, for which outcomes are worse. The sequence of critical events most likely to improve survival includes early identification of the cardiac arrest and notification of emergency services (call 084 124), performing CPR with minimal interruptions to chest compressions, confirming the rhythm and early defibrillation if indicated, and advanced life support care. Learn CPR for the sake of your loved ones,” said Robyn.
HOW TO PERFORM HANDS-ONLY CPR
•Make sure you are safe and not in harm’s way before you touch the person.
•If they show no signs of life OR are not breathing you are going to have to perform CPR.
•Shout for help and call the emergency number ER24 084 124.
•Make sure the person is lying on a hard, flat surface.
•Place the heel (palm) of one hand on the center of the chest, on the sternum. Place the heel (palm) of the other hand on top of the first hand, locking your fingers together.
•Keep your arms straight, elbows locked and position your shoulders directly over your hands.
•Begin chest compressions by pushing hard and fast, at least 100 – 120 compressions per minute, pushing down 5–7cm (in an adult).
•Keep doing this until help arrives.