help i am going into cardiac arrest

anonymous asked:

This may sound like a stupid question, but what's the correct method of doing CPR? My friend insists on a method that I believe is pretty outdated...

Hey. So I’m going to interpret this as a WRITING QUESTION. Because that’s what it is, right? Because you and your friend are writing a story together, right, and what needs to be done is a character needs to be resuscitated?

Side note: I am not a CPR instructor. I recommend everyone take a CPR for laypeople class, because to be honest, that’s literally the only thing that gives out of hospital cardiac arrest victims a fighting chance. The info in this post is current as of 2015, but it will probably all change AGAIN in 2020. But for the next 3-4 years, this should be helpful.

Now then. Your rescuer character is going to approach your victim character. Rescuer (R ) is going to going to put their hand on Victim (V)’s neck, on the trachea, and then slide over to the side. They’ll feel for a pulse for 5-10 seconds. If there isn’t one, or if they’re not sure—and even healthcare people aren’t sure sometimes–they’ll start chest compressions.

The current guideline for lay rescuers, to my knowledge, is to do continuous chest compressions and call for help. So you can imagine R pulling out their phone, calling 911, putting it on speaker, and then starting compressions.

As to how to do a chest compression? R will put their hand in the middle of V’s chest. On a male, the location is midline between the nipples. We used to have a better landmark system that worked for EVERYONE, but of course, the AHA had to change it, because the AHA like to make random changes that are stupid. On women, the only answer is “estimate where the nipples would be if they were a man”.

Look, I don’t make this shit up. I personally find the xiphoid process, which is the bony tip of the sternum, go 2 finger-widths above it, and put my hands there. That’s the old landmark, and it’s not inherently goddamn sexist. Seriously, have they never seen…. UGH.

Also, for any trans or gender non-conforming people who are feeling left out of medical guidelines: I’m sorry. I don’t make the rules. Most of medicine still sees “male” and “female”. I’m with you guys, that’s frikkin stupid, but that’s what it is right now.

Okay. Breathing.

Right. So your character is going to put their hands in the middle of the chest, and push. They’ll push hard, push fast, and—and this part cannot be overstated—they won’t lean on the chest (the current phrasing is “allow full chest recoil”). The whole reason CPR works is that you essentially use the lungs like a pump, pulling venous return from the rest of the body to keep blood flow going. So recoil is actually absolutely vital to a successful resuscitation. Even healthcare providers get this wrong, but it’s massively important.

Anyway, they are going to do that somewhere between 100-120 times per minute. The best thing you can do to keep the rhythm is to hum a song in your head. If R is optimistic, they can use Staying Alive (UH, UH, UH, Uh, Staying aLIve, Staying aLIve), but if they’re a morbid salty little shit like me, they might use Another One Bites the Dust (du-du DOO, DOO, DOO, +, ANOther one BITES the DUST…) . It is absolutely your call. Either one works. V will never know.

A solo rescuer, who is not a medically trained human, will just do continuous chest compressions until an ambulance arrives or the person stops being quite so dead.

However, when a second rescuer shows up, things change. Now we’re going to add rescue breathing into the mix. The ratio for adults and children is 30 compressions to 2 breaths. The breaths are given by tilting the head back, pinching the nose, making a seal with the mouth over the victim’s mouth, and blowing. If nobody is comfortable giving mouth-to-mouth—which is entirely possible, one of the things they don’t mention is that some cardiac arrest victims turn into just absolute fountains of vomit—then the two providers can trade off chest compressions.

And finally, if there’s an AED handy, they’ll apply it to the patient’s chest. The AED itself will walk them through what to do. It gives simple, clear instructions, such as:

“Apply pads to patient’s bare chest. Plug in pads connector.”
“Analyzing heart rhythm. Do not touch the patient.”
“Shock advised. Stand clear of the patient.”
“Press “Shock” Now.” (or) “No shock advised. If needed, continue CPR.”

It is made for lay people, but you cannot imagine how useful that is to offload during a cardiac arrest. Cannot. Imagine.

So that’s how CPR is done until an EMS crew arrives! Yaaaaaay!

Oh, one other thing, and this is pretty brutal: especially on an older person, ribs will break. I have done CPR on someone to the point that the sternum was completely disconnected from the ribs and was just…. Floating free on its own. It felt like doing handstands on oatmeal. This is a real thing, and it makes even veterans cringe. Your characters will feel this. Your characters will keep going.

I hope this helps your writing. And again: this is not medical advice. This post does not make you CPR certified. If you call 911 for a victim in cardiac arrest, the 911 operator will walk you through what to do. But do not do a thing and then say Aunt Scripty told you to.

Except in your writing. Do the thing in your writing, not in real life. Capisce?

xoxo, Aunt Scripty

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