CPR

[Pogue Mahone]

I'm no medic so I wouldn't assume I know what I'm talking about but I think the main aim of cpr is to maintain some flow of oxygenated blood with the hope of creating or maintaining a shockable beat (defibs can't be used if there isn't a shock able beat). I'd guess that the high failure rate relates to the cause of the heart stopping and if permanent heart damage has occurred and/or if the brain was damaged by a lack of oxygen.

Chest compressions are about trying to keep the brain perfused when the heart stops doing that job. They serve no other purpose.

Getting the heart back functioning again is more complicated. Sometimes defibrillation can help but not always. You can also inject drugs which kick the heart back into action. There may even need to be a surgical intervention. Generally the more interventions needed the lower the chance of a good outcome.

The best possible scenario is an arrhythmia (messed up electrical circuit in the heart) which a defibrillator can shock back to normality, without any other interventions needed. This seems to be what happened with Eriksen.

For me the most important thing for anyone to remember is the initial ABC assessment. When you’re in an (understandable) panic that might get forgotten and doing chest compressions on someone who doesn’t need them can do a fair bit of harm.

 

[Wibble]

Chest compressions are about trying to keep the brain perfused when the heart stops doing that job. They serve no other purpose.

Getting the heart back functioning again is more complicated. Sometimes defibrillation can help but not always. You can also inject drugs which kick the heart back into action. There may even need to be a surgical intervention. Generally the more interventions needed the lower the chance of a good outcome.

The best possible scenario is an arrhythmia (messed up electrical circuit in the heart) which a defibrillator can shock back to normality, without any other interventions needed. This seems to be what happened with Eriksen.

For me the most important thing for anyone to remember is the initial ABC assessment. When you’re in an (understandable) panic that might get forgotten and doing chest compressions on someone who doesn’t need them can do a fair bit of harm.

The one-time I had to do it I was glad I had been so well trained as it helped me just react without panic. Sadly in the days before mobile defibs but we did have oxygen resus equipment otherwise there is no way we could have kept going until an air ambulance arrived - we were on a GBR island resort.

 

[Salt Bailly]

I remember that! I wonder if that ad was produced off the back of a similar incident to yesterday? Maybe we'll see another one like it in the near future.

Shame Vinnie pumps too quickly and goes out of step with the music. Well done, you've killed him. Again.

 

[FattyFooty]

You push in time with the beat of the song.

So many kinda fast hard pushes. Righ on top of the chest?

 

[Wibble]

So many kinda fast hard pushes. Righ on top of the chest?

Yes but there is a specific pace and technique. Not that hard but you really need to do a course to get it right. I've done the course at least 15 times but not for about 6/7 years now so I'm going to do it again soon as a refresher.

 

[africanspur]

25% in hospital is very low isn't it? Eriksen is extremely lucky to be alive.

Its not that low when you think about what the process actually is. We're essentially trying to bring someone back to life who is dead.

Success rate improves with good quality, early chest compressions, being young and healthy, finding a reversible cause and what we call the shockable rhythms (VF/VT).

Its not for everyone and often the more humane thing to not do in much older patients with lots of medical problems who have a very low chance of success (though obviously only if that discussion has already happened with a medical professional).

 

[mav_9me]

What are the chances of surviving cardiac arrest for someone whom is out walking on a fairly busy street for example? I have nothing to back this up but it’s pretty much certain death isn’t it?

Among 70,027 United States patients prospectively enrolled in the CARES registry following out-of-hospital SCA between 2005 and 2012, survival to hospital discharge improved significantly from 5.7 percent in 2005 to 8.3 percent in 2012.

In a Canadian study of 34,291 patients who arrived at the hospital alive following out-of-hospital cardiac arrest between 2002 and 2011, survival at both 30-day and one-year increased significantly between 2002 and 2011 (from 7.7 to 11.8 percent for one-year survival). Similarly, among a cohort of 6999 Australian patients with out-of-hospital SCA resuscitated by EMS between 2010 and 2012, 851 patients (12.2 percent) survived for at least one year, with more than half of patients reporting good neurologic recovery and functional status at one year.

SCA stands for sudden cardiac arrest.

As noted above there are 4 types of cardiac arrests, 2 which are not shocked and 2 which are shocked.

The shocked ones are essentially the rhythm of the heart going haywire. When you are shocking you are hoping that energy jolt will reset the heart. Anyway in this type there is a semblance of activity which helps perfuse in addition to CPR. That's why they have higher chance of survival.

 

[BD]

I was at the finish line of a half marathon a few years back, just watching the people coming in. A guy came along and didn't look too good, but he just ran 21k and it was a hot day, so makes sense.

He then collapsed just after the finish line. Thankfully since it was an organised event, medics were there within seconds but they started doing CPR pretty much right away and continued while waiting for an ambulance to come. Ambulance finally came and used a defibrillator and he was brought away in the back of the ambulance.

I found out later that he survived, but that 10 minutes or so really shook me up. I was just there as a random passerby, and even then I was crying and had to sit down on a wall cause I felt like my legs were gonna give way. I felt like a right idiot at that point, but seeing someone dying right in front of my eyes, along with his worried family and friends standing there not being able to do anything, was a massive shock.

 

[mav_9me]

Chest compressions are about trying to keep the brain perfused when the heart stops doing that job. They serve no other purpose.

Getting the heart back functioning again is more complicated. Sometimes defibrillation can help but not always. You can also inject drugs which kick the heart back into action. There may even need to be a surgical intervention. Generally the more interventions needed the lower the chance of a good outcome.

The best possible scenario is an arrhythmia (messed up electrical circuit in the heart) which a defibrillator can shock back to normality, without any other interventions needed. This seems to be what happened with Eriksen.

For me the most important thing for anyone to remember is the initial ABC assessment. When you’re in an (understandable) panic that might get forgotten and doing chest compressions on someone who doesn’t need them can do a fair bit of harm.

Just a small clarification, CPR also serves to circulate the meds pushed. But yeah main purpose is to preserve blood and oxygen supply to the brain.

 

[Wednesday at Stoke]

If I see someone collapsed in a train station or some urban street, how do I know if they need a CPR or if its a passed out junkie? Are there any telltale signs of one thing or another? I'd much rather not start pumping someone's heart if all that's needed is to turn them over so they don't choke on their vomit. Should I check a pulse first?

 

[Pogue Mahone]

Just a small clarification, CPR also serves to circulate the meds pushed. But yeah main purpose is to preserve blood and oxygen supply to the brain.

Very good point.

 

[Wibble]

If I see someone collapsed in a train station or some urban street, how do I know if they need a CPR or if its a passed out junkie? Are there any telltale signs of one thing or another? I'd much rather not start pumping someone's heart if all that's needed is to turn them over so they don't choke on their vomit. Should I check a pulse first?

That is the ABC bit Pogue was emphasising. The best way to know for most of us is to do a First Aid and CPR course.

 

[Carl]

Chest compressions are about trying to keep the brain perfused when the heart stops doing that job. They serve no other purpose.

Getting the heart back functioning again is more complicated. Sometimes defibrillation can help but not always. You can also inject drugs which kick the heart back into action. There may even need to be a surgical intervention. Generally the more interventions needed the lower the chance of a good outcome.

The best possible scenario is an arrhythmia (messed up electrical circuit in the heart) which a defibrillator can shock back to normality, without any other interventions needed. This seems to be what happened with Eriksen.

For me the most important thing for anyone to remember is the initial ABC assessment. When you’re in an (understandable) panic that might get forgotten and doing chest compressions on someone who doesn’t need them can do a fair bit of harm.

What's the ABC Assessment?

 

[Wolverine]

What's the ABC Assessment?

Airway Breathing Circulation Disability Exposure
https://www.resus.org.uk/library/abcde-approach

 

[Pogue Mahone]

What's the ABC Assessment?

Airway, Breathing, Circulation.

Is their airway clear? Are they breathing spontaneously? Have they a pulse? Basically making sure they’re oxygenating their blood and pumping it round their body.

There’s a bit more to it than that. You can find all the info online. Better yet, go on a course!

 

[Carl]

Airway, Breathing, Circulation.

Is their airway clear? Are they breathing spontaneously? Have they a pulse? Basically making sure they’re oxygenating their blood and pumping it round their body.

There’s a bit more to it than that. You can find all the info online. Better yet, go on a course!

Was looking them up yesterday evening funnily enough. Isn't one local to me until October and St John's don't seem to be doing them anymore.

 

[Paxi]

Tweet

— Twitter API (@user) date

Not sure where to post this but it’s mind boggling that fellow people would actively go out and damage life saving equipment.

 

[Tibs]

On SportsBible, they posted the Danish team captain saying he'd given Eriksen CPR and stopped him swallowing his tongue before the medics.

Watch this re the swallow the tongue part, simple move to stop this happening

 

[Pogue Mahone]

On SportsBible, they posted the Danish team captain saying he'd given Eriksen CPR and stopped him swallowing his tongue before the medics.

Watch this re the swallow the tongue part, simple move to stop this happening

That’s a good vid. I like the shout out to the “very tough” frenulum. Not all frenulums (frenulae?) are very tough, unfortunately. As many a horrified sexual novice has discovered

@nimic

 

[Pogue Mahone]

Tweet

— Twitter API (@user) date

Fascinating thread for anyone who’s ever been trained in CPR.

 

[Salt Bailly]

I remember that! I wonder if that ad was produced off the back of a similar incident to yesterday? Maybe we'll see another one like it in the near future.

Shame Vinnie pumps too quickly and goes out of step with the music. Well done, you've killed him. Again.

Well it happened. A new British Heart Foundation ad about CPR just aired before the Bel v Den game. Fairly certain Vinnie Jones narrated it, too. Or a soundalike at least.