First aid, best chance: how your two hours could save someone’s life

Many people reach a point in their lives when they would like to be able to help someone in an emergency. Some people have a natural ability to calm an individual in a distraught state, while others have received formal first-aid training either through their workplace or through personal initiative driven by the desire to help a family member in difficulty.

For years, I have wanted to do a first aid course but simply haven’t gotten around to it. So, when the opportunity to do a short course in Cardio-Pulmonary Resuscitation (CPR) arose, I was pleased to take the opportunity. An awareness among friends and colleagues that few of us knew how to operate the automated external defibrillator (AED) in workplaces and sports centres also fuelled our interest to find out more.

Brigid Sinnott trained as a nurse and now runs courses in CPR with AED use for the Irish Heart Foundation (IHF). She set up an afternoon training session for The Irish Times that new staff of the IHF could also attend. The training, which is the standard course available to lay people, takes about two and a half hours.

With mannequins on the floor, we are taught how to give chest compressions to a person who has experienced cardiac arrest. Of course, in a real-life situation, you will have checked first that the person is unresponsive (ie, they can’t speak and aren’t breathing properly, even if they gasp for air occasionally), made sure you are in a safe place, and pulled the person’s clothes back to work on their bare chest on a firm, flat surface.

Sinnott stresses that the emergency services should be called before you begin – when there is someone else around to call them – or with a mobile phone on speaker while you are giving the compressions, if you are the only person on the scene.

“It’s always better to give CPR to someone who doesn’t need it than not to give it to someone who does need it,” says Sinnott, echoing the advice on the American Heart Association training video we are following.

Level of fitness

Practising on our mannequins, we quickly realise that giving compressions is hard work. The standard number of compressions to give is about 100 per minute, pushing down about 3cm using one hand over the over and allowing the chest to come back up between compressions.

“You need a certain level of fitness to give CPR, and that’s why we recommend people switch every two minutes when there is more than one person available to give CPR,” says Sinnott.

Next we learn how to give mouth-to-mouth resuscitation with and without a mask. Without a mask, this involves lifting the person’s head back, holding their nose and giving two normal breaths, watching to see if the chest rises after the breath.

With a mask, it’s important to make sure you have a good airtight seal around the mask. Masks are usually part of the AER kits, so are available when dealing with someone who has collapsed in a public place. “Some 65 per cent of cardiac arrests happen in the home, so people are more comfortable about mouth-to-mouth resuscitation with family members,” says Sinnott.

“The standard approach is to offer 30 compressions to every two breaths and never to interrupt compressions for more than 10 seconds. The first compressions are the most effective,” explains Sinnott.

Then, we are shown an automated external defibrillator. “Many people think that with AED there is no longer need for CPR but giving CPR doubles the chance of survival for someone who has had a cardiac arrest. The AED is required to get the heart out of its shockable rhythm. CPR alone can’t do that.”

The next step is for us to follow the audio instruction of the AED, which clearly instructs the helper to put the pads on the person’s chest, plug them into the machine, wait while the machine analyses the person’s heartbeat and then instructs the helper to give a shock.

The pads are left on the person until the emergency services arrive, with the helper following the machine’s instructions to give or not to give a shock. Volunteers should continue to give CPR to the person until the emergency services arrive.

“If the person comes around, you can stop the compressions, but the person will probably remain unconscious. The best CPR is only 25 per cent as effective as normal heart beating,” says Sinnott.

She stresses the importance of working as a team in emergency situations and ceding responsibility to the person most qualified to help. “Good quality CPR and AED use is what saves lives, and there are so many teams of community first responders now, who are usually at the scene before the ambulance services. “In fact, 122 lives were saved due to early CPR in the community,” she says.

Would you use a defibrillator?

With defibrillators in many offices, colleges and sports centres now, most people know what they look like; but would you feel capable to use one?

“Putting up an AED on a wall is no use on its own, especially if it is in a locked cabinet. People need to be trained how to use them. They need to know that they are easy to use and that the voice prompts tell you everything you need to do.

“If you start by giving CPR and then use an AED within a few minutes, you have the best chance of saving the person’s life,” explains Sinnott.

While there have been calls for a distribution map of AEDs across Ireland, Sinnott says, a national defibrillator register linked to the control rooms of the National Ambulance Service would be of more value. “And we need more community responders trained in their use,” she adds.

With up to 5,000 people dying of heart failure every year, the Irish Heart Foundation recommends more training and education about CPR. “Primary-school children should learn what CPR is, and when it’s needed, and specific training should be given to secondary-school students,” says Sinnott.

After only two and half hours’ training, I would now feel confident to do CPR and operate an AED, but I would always be happy to let someone more experienced or competent take over as soon as possible.

The Irish Heart Foundation has a list of training courses in CPR and the use of defibrillators on its website irishheart.ie

Five steps to saving a life: the chain of survival

1. Recognise there is an emergency and call for help on 999 or 112. 2. Once the person is in a safe place, lying on a firm surface, give CPR. 3. Make use of a defibrillator if available. 4. Continue to give CPR and use the defibrillator until the

emergency services/first responders take over. 5. Get the person to a hospital emergency department for

professional healthcare.