Certified ... To Pump Hearts?

Last week, I went on a mission to renew my CPR/First Aid/AED certification. It began with 200 minutes of online reading, videos, and practice exercises. I was awarded a temporary certification. And on Saturday, I met with my assigned instructor and three other strangers to complete the rest of my homework. 

Our next two hours of in-person classwork were fun ones. 

I became acquainted with a man and his 17 year old daughter. (Come to think of it, we never did proper introductions, so I have no idea what their names were.) They were very interactive and asked good questions. They also added funny comments to the discussion. While practicing all our newly acquired skills, they were a team.

The other participant was a man in his upper 20's with a bald head, pale skin, and round glasses. He is a teacher at a local school, he lives within several miles from my house, and that's all I know about him. 

(Oh, except that he appeared to have arrived early for the purpose of inhaling his breakfast just seconds before heading inside. I know this because I got there early as well. I wasn't entirely sure where we were meeting, so I thought if I got there early enough, someone else would be there to follow. And there he was innocently gulping food and chugging water in his car next to me. So as innocently and patiently as possible, I tried to make myself appear very occupied with something in MY car until he exited his and I had a chance to find out where I was going and follow him in.)

The instructor greeted us at the door and politely asked, "Are you two together?"

Oops. 

Since it was just the two of us left, we were paired up together as a second team to practice our newly acquired skills. And, frankly, I think we made a pretty good team because we saved many lives in the next two hours. 

After going over some initial slides, Instructor Bill introduced us to Preston. Turns out, Preston is a mannequin who has an alarming habit of periodically going into cardiac arrest. The dad and daughter were introduced to a mannequin named Preston too. Ironically, he has the same condition. After reviving them multiple times, their conditions worsened to where an AED was needed. Would you believe it? This habit is so periodic that they have developed sticky spots on their chests where the AED pads go! 

Anyway, we performed a large quantity of chest compressions, gave many rescue breaths, and delivered several jolts of electricity to Preston. We switched up our teams for several minutes and simulated back blows and abdominal thrusts on each other (notice I said simulated ... we didn't actually perform them! :) And then we went through all the steps again only this time, practicing on infant mannequins and modifying our techniques accordingly. 

Session one was complete, and we moved on to all things First Aid. Turns out, Mr. Teacher's calling in life is to be a teacher and not to deal with life threatening bleeding. He squirmed and cringed and shook his head a lot. And I tried not to laugh, but he made some pretty awful faces sometimes. He laughed too and admittedly agreed that blood is not his thing. But all bandages were properly secured and mental images of flowing, spurting, or gushing blood were stopped in our minds before any fainting took place. So session two was also a success. 

That completed, we packed up our things, thanked Instructor Bill, and left to probably never see each other again. 

But I've been thinking about this thing. Cardiopulmonary resuscitation. Everyone has a general idea of what it is and how to perform it. But so often, I get stuck on all the simple questions. Why does it work? How does it work? What actually happens when you rhythmically pump someone's chest? 

Doing all my online classwork and reading so much information on CPR was so much fun! I realized I had forgotten the stark reality that CPR is needed because someone's heart has literally stopped beating. It's sitting still inside the cage of protective ribs that surround it. 

And when it's not beating, oxygenated blood is not being forced through the arteries to all the organs, nor is the deoxygenated blood returning back to circulate through the heart. Additionally, when the respiratory system has stopped, the lungs aren't receiving the oxygen that the body needs or exhaling the carbon dioxide that does not belong in the body. And it only takes 3-4 minutes without blood flow to the brain before damage begins to happen. 

Cardiopulmonary resuscitation is literally pumping the heart manually. That's generally obvious information, but it hit me in a new way last week. In the event that Preston would have been a real person, I would have actually been forcing blood through his cardiovascular system with each chest compression. I would have been beating someone else's heart with my own hands! 

That's wild! 

But like alluded to previously, the heart is protected by the ribs. So to perform effective CPR, that's why you're instructed to push hard! Might ribs break? Yes, they might. But I think I'd rather have my life with a few broken ribs than no life and no broken ribs. If you're performing CPR on an adult, you should be pushing at least 2 inches deep. (In his unresponsive state, Preston still helped us, though. If we were compressioning appropriately, he would blink green lights. And if we did it incorrectly, he blinked yellow.)

If compressions are not given deep enough, the heart isn't able to circulate the blood. Therefore, it's ineffective. But along with "hard", think "fast"! Compressions should be given at a rate of 100-120 times per minute. However, if you are pushing too fast and not allowing the chest to return to normal, blood still isn't able to circulate. That's why I think it's important to practice the skill and get an idea of what normal compressions feel like. 

Okay, but all that said, I remembered again why it's crucial to begin CPR immediately. Especially if the person has been unresponsive for several minutes, it takes a while to get the blood actively circulating again. And the fact that I can do that by manually pumping someone's heart just blows my mind. We hope we never have to use those skills, but saving lives is kinda cool!

Add in the fact that you can actually shock the heart back to beating again; that's super cool! But that's another topic for another day.

I think I was reminded of how important it actually is to begin CPR as soon as possible. I've heard those words many times throughout my life, but it actually IS. It might not revive the person by the time EMS or other help arrives, but it begins to circulate crucial blood that was not previously moving through the body and most importantly the brain.  

And there you have a small essay about cardiopulmonary resuscitation, and now I have hopefully reemphasized in my own head some of the important concepts I want to remember from the classes. My certificate landed in my inbox one day later. I guess I'm certified to save your life now. Ha ha! It's funny if you say it that way. And now I'm just that much more passionate that everyone becomes certified.

So take classes! Because CPR saves lives! 

:D