Awareness May 21, 2021
Why you need to learn CPR
On the 29th of January 2020, in Bloemfontein, Bianca Victor received a call from her son’s nursery school. A teacher found the two-and-a-half-year-old Jeandré lying unresponsive on the ground.
The teacher performed CPR before ER24 medics arrived.
“When we got to the school, ER24 was busy with him,” recalls Bianca. “They shocked him nine times. While we were busy praying, ER24 medics shouted that they had a heartbeat. The medics said his teacher who started with CPR might have saved his life.”
WHAT IS CPR?
There’s no question – quick thinking and CPR saved Jeandré’s life.
Cardiopulmonary resuscitation or CPR is a series of first aid procedures and movements performed when someone’s heart and breathing stop.
“Its purpose is to restore cardiac activity and breathing in a patient,” explains paediatrician Dr Sanelisiwe Balfour, who has extensive experience in hospital emergency rooms.
“It works by administering chest compressions, in order to manually pump blood through the body and mimic the action of the heart, as well as giving breaths, to mimic the function of the lungs. The number of chest compressions differs in children, as compared to adults, because the size and physiology of children are different to that of adults,” says Dr Balfour.
So when a child collapses, what should be the first thing one does?
“A child’s heart is more likely to stop because of a lack of oxygen, while in adults the cause is usually from the heart itself. Therefore, we approach them differently,” explains ER24 Bloemfontein branch manager Lucas Bezuidenhout.
When you find yourself in the situation of a child who’s collapsed, first check their responsiveness. “[Then] determine the need to start CPR if trained to do so,” says Bezuidenhout.
SAVING A LIFE
Jeandré’s story shows that bystander CPR can be lifesaving. Bezuidenhout notes that even four minutes without oxygen to the brain can be detrimental.
“Early CPR may definitively be beneficial to try and restore oxygen to the brain and get the heart going again. Emergency services react as soon as they receive the call, but their response may invariably be influenced [by] distance to the scene, traffic and road conditions, and accurate information as well as the availability of resources. I would definitely recommend that you do something rather than nothing in an attempt to save a life”, says Bezuidenhout.
And if there’s one main lesson you should take from this, it’s the importance of CPR training.
“Ideally, all persons should have the knowledge to perform hands-only CPR. There are various platforms where CPR can be learnt, [together with] institutions [that] offer first aid courses. CPR is a fundamental part of any first aid course. ER24 often do outreaches to schools where we teach basic CPR,” says Bezuidenhout.
WHAT TO DO IN AN EMERGENCY
If you are reading this and are still waiting for your course day training, have these points in the back of your mind for whenever an emergency hits:
- According to the Resuscitation Council of Southern Africa, you should check the scene and the collapsed person. Then firmly tap on their shoulders and shout: “Are you OK?”
- Check to see if the person is breathing by only looking for chest rise and fall. For infants, flick the bottom of the foot to elicit a response.
- If the child is unresponsive and not breathing or only gasping (occasional gasps isn’t breathing), call for help. “ER24 has a national emergency number 084 124 that is manned by trained persons who can assist and guide on telephonic CPR in case of an emergency situation until emergency services arrive,” says Bezuidenhout.
COVID-19 AND CPR
The recommendations below are based on expert opinion. They will reduce the risk of the public responder getting the virus from the person when providing CPR and using an AED during cardiac arrest. They are modifications of usual Hands-Only CPR to be used only during the COVID-19 pandemic. They apply to both adults and children.
According to Heart and Stroke, if you encounter a person who may be in cardiac arrest during the COVID-19 pandemic and you feel comfortable helping the person while reducing the risk of COVID transmission you should apply the following modified CPR steps:
- Check for signs of cardiac arrest: recognise cardiac arrest by no response when you shake and shout AND the person is not breathing or is making strange gasping sounds. Do not listen or feel for breathing by placing your ear and cheek close to the person’s mouth, simply observe the person’s breathing.
- Call 084 124 and tell them you have found someone unconscious and not breathing normally. Tell them if COVID-19 is suspected.
- Prevent contamination: lay a cloth, towel, or clothing over the person’s mouth and nose to prevent any potential spread of the virus through contaminated air or saliva.
- Provide Hands-Only CPR: Push hard and fast in the centre of the chest with one hand on top of the other. Think of the beat of Stayin’ Alive or about 100-120 beats per minute. Don’t stop until the ambulance arrives. Do not give rescue breaths. The emergency service dispatcher will coach you if necessary.
- Use an automated external defibrillator (AED) if available. AEDs are safe and simple to use. Turn it on and follow the voice prompts.
Hygiene and cleaning after attempted resuscitation:
After paramedics or first responders take over the resuscitation, wash or throw away the cloth, towel, or clothing used to cover the person’s face. Then you should wash your hands thoroughly with soap and water; alcohol-based hand gel is an alternative.
The above procedures apply to the majority of cases of sudden unexpected cardiac arrest. In some circumstances, you may choose to provide additional treatment if you are trained to do so. You should only do so if infectious transmission of COVID-19 is not a concern to you (e.g. the person is known to you).
These situations include:
- A witnessed overdose caused by opioids (use Naloxone and rescue breathing, then chest compressions if no response)
- A witnessed drowning (rescue breathing and chest compressions)
- Cardiac arrest in a child (rescue breathing and chest compressions)
Clinically reviewed by Dr Vernon Wessels.