‘Get me an AED stat and call for help at once. Good God, people! We have a life to save!’

I’m seated alone at a long row of tables, the blank faces of nine dummies staring back at me. There is no soul behind those eyes, but they seem filled with condemnation nonetheless.

I know what they’re thinking: It’s shameful how I’ve spent two decades working the crime beat yet I’ve never taken the time to get first-aid training.

It’s a sad truth, and before those 18 empty eyes, I squirm with shame.

But that changes today. Today I’m at the Androscoggin County Chamber of Commerce in Lewiston to take in a few hours of training in CPR and the use of an automatic external defibrillator, or AED. I’ll also learn to treat external bleeding, choking, shock and cardiac arrest, and it’s all courtesy of Paulette Dingley, health and safety instructor with the American Red Cross.

Dingley also teaches wilderness rescue and how to administer CPR on dogs and cats. Today, though, she’ll be teaching me and roughly a dozen others how to diagnose, react and bring on the care. With the class set at under three hours, there’s little time for goofing off. Dingley gets right to it.

“I may be the one who needs your help someday,” she tells us. “I want to make sure you know how to do these things correctly.”

And who are these people she means to instruct?

There’s a young mother who came from the Wayfinder School, where first-aid training is mandatory. That’s OK, the young mom tells me. She’s always wanted to learn this stuff, anyway. Getting her certificate will just be a bonus.

There’s a man and woman from a local church group that goes on frequent outings. This is Patrick Finn and Wendy Therrien, she with a background as a medical first-responder. Sometimes parish members go to areas far from phones, ambulances and emergency rooms. If a church member were to suffer a heart attack, stroke or injury, who could be called upon to render aid?

“Patrick is usually present with the children at teen happenings and I am here at the office as well as at other parish functions such as Mass, etc.” says Therrien. “I was interested in brushing up my skills and seeing what the new techniques were, as well as really being interested in the use of AEDs to see if that is something the parish should look into purchasing for the churches.”

There are many like me – they’ve always wanted to learn CPR but never got around to it, until they grew up a little and saw their priorities shift.

There are those who are leading by example, getting the training so they can pass it on to employees or co-workers.

Steve Boulet, who would be my practice partner on the various drills, is one of these. A human resource manager at an Auburn manufacturing company, the business angle was one of motivation. But it wasn’t the only one.

Years ago, Boulet watched as his wife rushed to the aid of a boy who began choking at a restaurant. Everything turned out OK with the choking lad, but Boulet never forgot the rush of witnessing someone in distress and wondering what more he could have done.

“Obviously it made enough of an impact on me,” Boulet says, “that I was determined to once and for all take the CPR class.”

Sometimes it’s an active imagination that compels a person to learn life-saving skills. Boulet thinks of all the trips he makes with his father-in-law to their camp deep within the woods of Eustis. What if the older man were to suffer a cardiac event? What if he were to choke or fall or to experience any of the myriad ways the wilderness can hurt a man?

Go ahead and imagine these things, says Dingley. In fact, she presents us with a variety of scenarios to ponder:

* You’re at a work site when an accident – an explosion, say – leaves several people with a variety of injuries, some minor, some potentially deadly. How do you prioritize? Who needs help the most and how are you to provide it? At what point do you need consent to render aid and exactly when do Good Samaritan laws come into play?

* You’re at a restaurant when a stranger at another table begins to choke on his food. Nobody else is rushing to help. Should you? Are there legal ramifications? Is the process of life-saving just too downright gross to consider?

“We all are going to have some kind of barrier,” Dingley says.

We talk about those barriers at length, trying to pin down exactly what might prevent us from jumping to action when action is needed.

Steve and I agree on our biggest concern: Doing more harm to the victim than good, either through our own incompetence or plain bad luck. It’s a concern shared by many in the group, while others are troubled by the thought of legal action (you jump in to help, only to get sued by the victim or his family). In such cases, Maine law shields you from liability if you contribute to someone’s injury or death while trying to help them, unless your actions are found to be reckless or negligent.

Others have health considerations (you render mouth-to-mouth resuscitation and contract some horrible disease).

And there were those who worry they might turn squeamish in the face of vomit, spit, blood and other unpleasant tricks of human anatomy.

“The human body,” Dingley tells us, “does some very gross things during life-threatening emergencies.”

We all have barriers, sure. But the fact is, if we weren’t earnestly interested in learning to help our fellow man, we wouldn’t be here studying the guides and getting up close and personal with strangers.

Quit it, that tickles

In your head, you imagine yourself swooping in to save the life of another with heroic skill and confidence, barking orders at impotent bystanders and generally gettin’ ‘er done.

“Get me an AED stat and call for help at once. Good God, people! We have a life to save!”

Cue the sputtering sounds of life from our hapless victim, a swooning heroine and, finally, applause from the crowd of people fortunate enough to have witnessed our life-saving know-how.

Dingley is quick to point out the many variables that can make rendering aid less than a smooth and clean operation. Maybe the person in distress doesn’t want your help and will actively fight you off. Maybe the downed person is a kid and a parent doesn’t want you anywhere near the child – consent is required in some circumstances, although there are laws, varying state to state, to protect the well-intended caregiver.

Or maybe you just can’t find the poor fellow’s belly button.

For much of the class, we were hands on. There were floor drills, for instance, where we learned how to properly roll a victim onto his back so that we could begin rendering aid. Here we also learned the proper procedures for head tilts, checking the mouth for obstructions and checking for signs of respiration.

We performed abdominal thrusts (which is no longer called the Heimlich maneuver for some reason) on one another to simulate the method of treating a choking victim. It’s an up-close and personal drill.

“You’re literally trying to knock something out of their airway,” Dingley tells us. “Get in real close, even if you don’t particularly like the person.”

I liked Steve just fine, but for a few awkward seconds, I was unable to locate his bellybutton in order to perform the thrust in exactly the right spot. When the pressure’s on the rescuer – and the pressure of the classroom pales before the pressure of real-world emergencies – things don’t magically arrange themselves so you can play the hero.

Once the bellybutton matter sorted itself out, the procedure was fairly simple: a thrusting in and up of the fists in an attempt to blow the clot of hot dog or lobster Newburg out of the presumably choking man’s airway.

To my surprise, back blows are still used, in conjunction with abdominal thrusts, to dislodge an object or food from the throat. For five minutes we gathered in the center of the room, delivering back blows in slow motion and squeezing each other around the midsection, at the same time trying to support our victim’s weight in one arm.

Tricky stuff, not nearly as neat and simple as Hollywood would have you believe.

And then there are heart attacks, the Big Daddy of health emergencies. There are 800,000 of them each year in the United States, you know.

“Most people having a heart attack are conscious,” Dingley tells us. “The victims describe the attacks as horrifying.”

In the matter of a heart attack, seconds count. We don’t pause to check for a pulse anymore because it takes too damn long and most people don’t know how to do it correctly. We call 911 or we have someone do it for us. We request an automatic external defibrillator if one is available – lots of places keep them on hand these days, including many schools, libraries, banks and government buildings.

“They’re really becoming more common,” Dingley says, “out in our communities.”

We get down close and try to breath life back into the dying, through mouth-to-mouth and/or chest compressions, a procedure we’ve all seen a million times on TV, in the movies or in real life.

The Red Cross doesn’t want its students breathing into one another, so at this point the dummies come into play. To my great disappointment, they don’t call them Resuscitation Annie anymore – they don’t give them names at all, although I secretly named mine “Salma.”

There is nothing particularly difficult about performing chest compressions, although the depth at which the chest actually compresses is more than a little unsettling. Doing this on Selma is straightforward. On a living person, with tissue and bone, there may be strange sounds from within. There may be vomiting and cracked ribs. There may be screaming and crying from above and well-meaning people interfering with your efforts.

No matter.

“You’re going to do CPR the best you can for as long as you can,” Dingley advises. “Until an AED is available.”

Performing CPR, alternating between mouth-to-mouth and chest compressions, is tiring work. We’re talking 30 compressions followed by two breaths into the mouth of the victim, and then over and over again until medical crews arrive or an AED is brought to the scene.

The AED devices of today are cool little gadgets. The technical definition goes like this: “A portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to re-establish an effective rhythm.”

You, the caregiver, are responsible for attaching the electrode pads to the upper right and lower left areas of the chest. This will likely mean removing shirts, straps and anything else that might impede the AED’s operation. Fortunately, Salma doesn’t have on any clothes or any bling, so I have the pads stuck on in seconds.

From there, the digital device itself will deliver the diagnosis and give advice about the next step. Clear bystanders away from the victim. Press a button and wait for the shock. Then await the next diagnosis and proceed accordingly. So simple to use and of such life-or-death importance to one in distress that it’s a marvel we all don’t carry one in the trunks of our cars.

Saving lives, like on ‘Emergency’

We have treated the bleeding, the choking and the cardiac arrested. It’s a lot of information crammed into just a few hours. Other than the notes written in your own notebook, there are no materials to carry away from the class.

Still, in just one class, we learned skills that might mean the difference between somebody – a loved one or a stranger – living or dying.

“The more people that at least know the basics, the more chance that someone’s life will be saved,” says Therrien, a former first-responder and instructor for Buckfield Rescue. “I particularly liked the talking AED! Nice, clear instructions for when the adrenaline is pumping and you can’t really remember what it was that instructor taught you so very long ago. Or maybe I just liked the fact that I could yell at the bystanders like I was on the squad of Station 51 helping save a patient, to then transport to Rampart Hospital on ‘Emergency!’ It definitely was a worthwhile class.”

Adds Boulet, who survived my clumsy bear hugs, “Overall I thought the class was useful, but for me I’m a hands-on learner, so I would need to practice a few times. Fortunately I’m going to be offering it at my work, so I’ll get a chance to revisit the steps.”

We all learn in different ways

In at least one case, it has been reported that CPR techniques learned from a movie were used to save another person’s life. In April 2011 in Arizona, it was claimed that 9-year-old Tristin Saghin saved his sister’s life by administering CPR on her after she fell into a swimming pool, using only the knowledge of CPR he had gleaned from the motion picture “Black Hawk Down.”

Source: wikipedia.com

Read more: cnn.com/2011/US/04/19/arizona.boy.saves.sister

To find out more about taking a CPR/AED class visit: redcross.org/me/take-a-class

Cardiopulmonary resuscitation facts:

* CPR alone is unlikely to restart the heart. Its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage. Administration of an electric shock to the subject’s heart, termed defibrillation, is usually needed in order to restore a viable or “perfusing” heart rhythm. 

* CPR has continued to advance, with a greater emphasis on constant, rapid heart stimulation, and a de-emphasis on the respiration aspect. Studies have shown that people who received rapid, constant heart-only chest compression are 22 percent more likely to survive than those receiving conventional CPR that included breathing. What’s more, because people tend to be reluctant to do mouth-to-mouth, chest-only CPR nearly doubles the chances of survival overall, by increasing the odds of receiving CPR in the first place.

* In the 19th century, Dr. H. R. Silvester described a method of artificial respiration in which the patient is laid on their back, and their arms are raised above their head to aid inhalation and then pressed against their chest to aid exhalation. The procedure is repeated 16 times per minute. This type of artificial respiration is occasionally seen in films made in the early 20th century.

* A second technique, called the Holger Nielsen technique, described in the first edition of the Boy Scout Handbook of the United States in 1911, was a form of artificial respiration where the person was placed face down, with their head to the side and resting on the palms of both hands. Pulling the patient’s elbows upward raised the upper body in an effort to fill the lungs with air, while pressure on the back forced it out, in essence the Silvester Method with the patient flipped over. This form is seen well into the 1950s (it is used in a T.V. episode of “Lassie” during the mid-1950s), and was often used, sometimes for comedic effect, in theatrical cartoons of the time (see Tom and Jerry’s “The Cat and the Mermouse,” 1949). This method would continue to be shown, for historical purposes, side-by-side with modern CPR in the Boy Scout Handbook until its ninth edition in 1979. The technique was later banned from first-aid manuals in the UK.

* Similar techniques were described in early 20th century ju-jutsu and judo books as being used as far back as the early 17th century. A New York Times correspondent reported the techniques being used successfully in Japan in 1910.

Source: wikipedia


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