As we all know performing cardiopulmonary resuscitation in a training environment such as the one you take your CPR certification in is completely different to performing it in real life. Apart from the obvious fact that you could prevent a sudden cardiac death, there may be other medical conditions that are complicating the treatment.
In most cases of cardiac arrest in adults, the arrest is caused by an abnormal rhythm and the casualty should hopefully respond well to early CPR and the use of an AED device. Your CPR training will also enable you to give assistance to hopefully prevent a sudden cardiac death.
What if the victim suffers a heart attack?
While you do not use cardiopulmonary resuscitation on a heart attack victim unless of course they have gone on to have a cardiac arrest, you need to be aware that an arrest is quite possible. A heart attack can be caused by many different events but the main cause is a sudden blockage of the blood supply into the heart. The risk that the heart will arrest is very high and depends on what part of the heart muscle is affected and how badly.
One reason why you are recommended to give a heart attack victim who is fully conscious 300 mg of aspirin is that this drug has a dissolving effect on the clot. It will thin the blood but medical attention is still required and you should by now have called 911. You would never give any medication to someone who was losing consciousness as it would be choking hazard.
If the patient has a history of heart disease he may have a pump or spray that could help while you are waiting for the emergency services. Ask someone to get an AED just in case you have to start CPR. The patient is at risk of shock too which is also life threatening. They are bound to feel anxious and you need to do your best to reassure them and keep them comfortable. Keep the patient warm and if you can move their legs into a higher position without compromising their safety do so. It will improve the blood supply to the brain and other vital organs. Do not let them eat, drink or smoke even if they say it will calm their nerves!
Can you perform CPR on someone who has internal bleeding?
If you come across an accident, you may have to consider performing CPR on someone who potentially has internal bleeding. This is obviously not a decision you would like to have to make but if you have passed your CPR certification you may be the only one who knows how to perform cardiopulmonary resuscitation properly. The key to remember is that if the victim has had a cardiac arrest they will die if you don’t do anything. Someone should have called 911 and they can usually give you an estimated time for arrival. But it is highly unlikely the emergency services will arrive on the scene in time particularly if you are in a remote location or there is heavy traffic. Part of the role of the bystander rescuer is to buy the casualty time to allow the emergency services to be able to assist them when they arrive.
The victim may have internal bleeding and you may make this worse by performing chest compressions but they will die if you don’t. Ask your CPR instructor the next time you attend a refresher course for recommendations on how you would deal with this potential situation. You never know for definite if someone has internal bleeding but it should be suspected if blood is leaking from a body opening including their mouth, ear and nose.
Cardiopulmonary resuscitation does prevent sudden cardiac death
It is a scientific fact that CPR does save lives particularly when done properly and as soon as possible after the casualty falls ill. But there will be times that no matter how experienced the rescuer, the victim will die or be left brain damaged. It is important that you accept this fact. Your CPR classes will teach you how to save someone else’s life but also how to deal with the stress caused by an emergency situation.
You cannot beat yourself up if you perform cardiopulmonary resuscitation on someone who later dies. They would have definitely died if you hadn’t tried to help and the fact that you did gave them a chance, albeit a small one, that they could have survived. Ask anyone who has survived a cardiac arrest due to the intervention of someone who performed CPR if they are grateful they met that person. Their answer shouldn’t surprise you!
John Furst
JOHN FURST is an experienced emergency medical technician and qualified first aid & CPR instructor. John is passionate about first aid and believes everyone should have the skills and confidence to take action in an emergency situation.
