First Aid Course

There was an interesting article a few days ago in the newspaper about this girl called Esther in ACS (I didn't know ACS had girls?!) who performed CPR on a heart attack victim. Her efforts bought enough time to keep him alive.

Student, 17, keeps heart attack victim aliveBy Jessica LimTHREE times, the news magazine vendor's heart appeared to have stopped beating. It made 17-year-old Esther Tan's heart skip a beat too. But she battled on, pumping the man's chest and giving him mouth-to-mouth resuscitation. Then, professional help came. Esther, a student at ACS International, may well have saved the life of a familiar figure in Holland Village - Mr Logadasan, or Uncle Loga as he is known at Mama Joe Magazine Corner. Esther and three friends were having breakfast at Crystal Jade Kitchen yesterday morning when they heard a scream across Lorong Liput. Uncle Loga, who is thought to be 72, had keeled over, seemingly from a heart attack. Pushing through the gathering crowd, Esther applied what she had learnt at a Singapore Civil Defence Force (SCDF) course and at the Singapore Red Cross Society - cardiopulmonary resuscitation or CPR. 'It took me a few seconds to play out the entire CPR procedure in my head before actually performing it,' she told The Straits Times. She continued for six minutes, before SCDF paramedics arrived. Mr Logadasan, who has an ailing wife and a daughter working in New York, is now in the intensive care unit at the National University Hospital. Said an SCDF spokesman: 'When the victim collapsed he had no pulse reading. The actions of the bystander in keeping his heart alive with CPR, helped our paramedics bring his heartbeat back to normal. And that gave him a fighting chance of survival.'

This is truly impressive; you might be interested to read Book of Aletheia's interview with Esther. Last month, I attended the basic 4-day, First Aid course at the Red Cross, and today I went back there to collect my Red Cross First Aider card. It basically says I know a little bit about first aid and can thus be considered a certified first aider, and that if you should ever have a cardiac arrest right in front of me, I shall try my best to save you. But seriously, it's not easy. No matter how many times you rehearse the Airway, Breathing, Circulation mantra in your head, in an emergency, everything can just go blank. That's why I think Esther deserves a medal or something... Anyway, I think everyone should go and learn first aid. One reason is that if a loved one is in real trouble, at least you might be able to do something to help, rather than be completely helpless. Time is of the essence. A person with no bloodflow to the brain has only four minutes to survive. An ambulance will take at least 10 to 15 minutes to arrive, which is too late. Obviously no one can guarantee that a person who takes a first aid courses can perform as well as Esther did, but at least there's a fighting chance that might happen. The Red Cross, and St. John's Ambulance, regularly hold courses. Go sign up, and maybe save your own life in the process, if you happen to choke on your own food. (Yes, they taught that in the course, but I've forgotten how to do it! I'll go read up on it again soon...) Update(!): New guidelines for CPR were released today. Read the details here.

Only 1 in 5 who has cardiac arrest given CPR Lack of confidence, apathy may be reasons many bystanders do not attempt procedure By Radha Basu ABOUT only one in five people who suffers cardiac arrest here receives cardiopulmonary resuscitation (CPR), doctors said at a seminar where they released new guidelines on the proper way to perform this life-saving routine. The help rate is low compared to places such as Seattle in the United States, where more than half the victims receive CPR. The procedure is performed on patients who suffer cardiac arrest, a condition where the heart stops functioning suddenly. Such an attack occurs when heart abnormalities, such as a blocked artery, hinder blood flow and starve the brain of oxygen. It can kill in five to 10 minutes. CPR involves pressing a victim's chest repeatedly to restart blood circulation. It also involves offering mouth-to-mouth resuscitation, to help the patient breathe. It can be performed by trained personnel only so it is imperative for more people to undergo training, said cardiologist Teo Wee Siong, a senior consultant at the National Heart Centre. About 30,000 people, mainly health-care professionals and emergency workers, receive CPR training here every year. But this number could include repeat attendees as health professionals in public hospitals are expected to renew their training every two years. 'One of the big problems is that in about four in five cases, bystanders do not even attempt resuscitation,' Dr Teo said yesterday. He suspects that in some cases even those who have undergone training may not attempt to revive a patient as they are not confident enough. 'That must change.' Senior Minister of State for Health Balaji Sadasivan also backed the call for more CPR training while speaking at the seminar yesterday. 'The public mindset must change, from apathy and the belief that learning CPR is someone else's duty, to one of shouldering the responsibility, not only for oneself, but also for the community.' In Singapore, only about 5 per cent of people who suffer cardiac arrest outside hospitals survive, said Dr Lim Swee Han, head of emergency medicine at Singapore General Hospital, who did a study of survival rates of 1,000 such patients. However, survival chances double if patients are given prompt CPR. Timely use of machines known as automated external defibrillators, or AEDs, that can shock the heart back into action, also boosts a victim's chances. Aside from training emergency personnel and lay people, some countries have targeted CPR programmes, said Dr Lim. In some places, high school students, for instance, are trained. In others, employees at places where people have been known to suffer cardiac arrests - such as casinos, airports and sports stadiums - are given special training. Such targeted training has proved effective in the US, said Dr Michael Sayre, an associate professor of emergency medicine at Ohio State University. If there are no trained personnel around to offer CPR, bystanders should call an ambulance immediately, said Dr Teo. 'Too often people wait too long and it's too late.' Nurse manager Ismail Sheriff, 53, who has undergone CPR training, could not agree more. A few years ago, he received a frantic phone call that his 72-year-old neighbour had collapsed with chest pains. He rushed over and tried to revive the unconscious woman. But it was all in vain - she was dead. 'It was only later that I realised that they had called me more than 20 minutes after she had collapsed,' he said. 'It was much too late.' radhab@sph.com.sg ----------------------------------- New guidelines DURING CPR, rescuers need to frequently press hard against a victim's chest and offer occasional mouth-to-mouth resuscitation. New CPR guidelines released here yesterday say rescuers need to perform at least 30 chest compressions followed by two rounds of mouth-to-mouth resuscitation. Earlier guidelines said only 15 chest compressions were required. Studies have shown that a victim's blood pressure may fall if chest compressions are done only 15 times in a cycle. Chest compression jump-starts blood circulation. Mouth-to-mouth helps the victim breathe. CPR should begin within four minutes of a person collapsing. Rescuers should also:

• Push hard and fast, pressing the chest at the rate of about 100 compressions per minute.
• There should be no interruptions in the 'pump and breathe' routine. CPR should continue till paramedics arrive.

More information can be found at 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Parts 4 and 11 elaborate on the rationale for the new 30:2 ratio.