CPR: Why You Should Jump on a Stranger’s Chest

We’ve all seen spectacular examples of CPR (cardio-pulmonary resuscitation), especially on TV, where it leads to equally spectacular results: the previously pulseless patient sits up and tucks into pizza while vowing undying love for his family.

CPR ventilating with bag

In real life, the story is different. Outside Casualty, Grey’s Anatomy, and other small screen dramas, CPR is far less successful. Cardiac arrest in hospital has a survival rate of around 35%. Out in the big wide world, survival is more like 8%. This UK figure is especially dismal when compared with other western countries.

I learned all this and more at a CPR refresher course this week, courtesy of the Hospital of St John and St Elizabeth in North London. Tutor Philip Howarth is a brilliant mimic as well as a gifted teacher, and he was assisted by his fellow resuscitation officer Christilene Kiewiets. I can’t actually think of a more worthwhile way to spend a rainy Wednesday afternoon.

CPR manequin

We went through various scenarios of increasing complexity, but the principles are simple and they’re things everyone should know.

In a cardiac arrest, the heart stops pumping. This deprives the body of vital oxygen.

After five minutes without treatment, this damages the most important organ in the body (that’s the brain, in case you wondered).

CPR buys time. After a cardiac arrest, it can keep life going for up to 20 minutes (possibly even longer). That means time for paramedics to get there.

But CPR needs to start as soon as possible, ideally within two minutes.

Classic CPR uses chest compression and rescue breaths (in a ratio of 30:2 for adults). But hands-only CPR is a useful alternative. (Chest compressions make the lungs move, so they deliver some ‘breaths’. And people are more likely to give CPR to strangers if they can avoid mouth-to-mouth.)

Chest compressions should be fast and deep. A rate of 100-120 compressions a minute (two per second) is better than the old advice to keep time with the BeeGees’ Stayin’ Alive. ‘Deep’ usually means to a third of the depth of the chest. It’s tiring, and it can be noisy. The sound of ribs cracking is par for the course.

AED

Defibrillators can make all the difference to the outcome. In the UK there’s an increasing number of public-access defibrillators in airports, stations, and the like. The best bit is that these automated defibrillators are very easy to use, with voice prompts that are simpler and far more reliable than sat nav.

The most important thing of all?

Have a go. If someone has a cardiac arrest and you stand idly by, that person is dead. So there’s nothing to lose.

If you’re wondering about the best place to cash in your chips, a Las Vegas casino is probably the safest location of all in which to suffer an out-of-hospital cardiac arrest. Security guards trained in CPR and the prompt use of defibrillators can achieve impressive results.

FreeImages.com/Bob Townsend

Photo credit Bob Townsend

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The free app Lifesaver is a live-action movie you play like a game. It’s a great way to learn how to save someone’s life.

The British Heart Foundation runs HeartStart training courses around the UK.

First aid courses for the public offered by other charities such as the British Red Cross also include CPR.

Some ambulance instructors also teach the public. Get in touch with the Community Defibrillator Officer or the ambulance training school nearest you for more details.

The latest Resuscitation Council UK guidelines can be found here.

Here’s an easy tweet:

CPR: Why You Should Jump on a Stranger’s Chest http://wp.me/p3uiuG-1qC via @DrCarolCooper #CPR #cardiacarrest 

What You Can Do for London’s Lungs

Take a nice deep breath. For thousands of people living in London, that’s a luxury.  

FreeImages.com/Christina Papadopoullo

With its plethora of parks, our capital may be one of the greenest cities. But it’s also one of the most polluted. For the last five years, London has been in breach of EU safety limits on NO2.

I’ve noticed it getting worse. For an instant lesson in air quality, head for the outer reaches of one of the Tube lines and see how fresh the air feels when you step outside. 

Pollution isn’t just an irritant to the throat, nose, or eyes. It’s damaging to health, increasing the risk of lung cancer and chronic lung disease, and driving up hospital admission rates for those with pre-existing lung or heart disease.

FreeImages.com/Dave Kennard

Children’s lungs are most vulnerable, yet around 330,000 London kids go to school in areas with illegal levels of pollution.

Pollution has also been linked with damage during pregnancy, including low birth weight and pre-term birth.

I’ll cut a long story short: at least 9,500 deaths a year in London are linked with air pollution.

We may not have the pea-soupers of the 1950s that smothered London in soot and sulphur dioxide for days at a time. But we have a haze of small particles, especially PM2.5s, along with the toxic gas nitrogen dioxide NO(not to be confused with laughing gas because this one isn’t funny).

FreeImages.com/Simon Gray

PM2.5s are fine particles, less than 2.5 micrometres in diameter. They come from things like motor vehicles, power plants, and wood-burning, and they’re harmful because they’re small enough to reach the deepest recesses of the lungs.

Nitrous oxide comes largely from diesel cars, lorries, and buses. It follows that pollution is worse near busy roads, which is often where less advantaged families live. But even short-term exposure to air pollution can damage.

Why am I banging on about it now?

Because on May 5, London elects a new Mayor. As a parent, a doctor, and a Londoner, I whole-heartedly support The British Lung Foundation’s #Londonlungs campaign. It calls for the next Mayor and Assembly members to prioritise lung health.

FreeImages.com/Andrew Rigby

So much could be done, from tree and hedge planting schemes to improving transport strategy and extending the ultra-low emission zone (ULEZ) eastwards – where there’s a lot of deprivation and air pollution.

You too can help by getting on board and asking all the mayoral candidates whether they pledge to protect Londoner’s lungs. You could also share the campaign on social media with the hashtag #Londonlungs.

FreeImages.com/Adam Ciesielski

What else can you do?

There are obvious individual steps to help protect the lungs and heart, like not smoking.

Driving less, for instance by sharing cars or using public transport, helps drive down vehicle emissions. If you’re buying or leasing a car, choose a low-emission model.

Take the longer route on foot or cycle via a less polluted area if you can. You may be interested in the Clean Space app

The British Lung Foundation has some great tips for when air pollution levels are very high. You can find them here