6/22/2012 - JOINT BASE SAN ANTONIO-RANDOLPH, Texas –
Dan Flores, Joint Base San Antonio-Randolph Fire Emergency Services lead firefighter, recalled performing cardiopulmonary resuscitation limitedly in his lengthy career.
"I've been doing this for 25 years and I have done CPR four times," he said.
However, Flores said it is not the number of times he's performed the procedure that matters, but rather possessing the know-how and situational awareness of when to use CPR that counts.
"You can go years without using it, but you must always be ready," Flores said.
Not everyone is trained or certified in administering CPR, but lack of necessary action from people around a cardiac arrest victim will guarantee a "0 percent chance of survival" for the victim, Jerry Knopf, Randolph FES paramedic, said.
Some obvious signs of when a victim enters cardiac arrest and is not breathing include: a victim grabbing his chest, the victim's chest not moving, the victim's face turning a blue or grayish color, the victim not responding to painful stimuli such as a pinch to the arm and the victim experiencing agonal gasps, Knopf said.
Agonal gasps are characterized by sudden, strange noises that resemble snores without accompanying chest movements, which can sometimes "scare people into not acting" because of their unnatural appearance, Knopf said.
Recognizing a person becoming breathless and pulseless, followed by calling 911 and enacting CPR, can shave minutes off the clock, especially when timing dictates life or death; every minute cardiac arrest victims do not receive treatment reduces their chance of survival by 10 percent, Knopf said.
According to steps compiled by the American Red Cross for performing CPR on an adult, check the scene for safety (for the protection of the first responder) and if the scene is safe, check for unconsciousness.
Ask the person, "Are you OK?"
If the person does not answer, check for signs of life like breathing, which should take 10 seconds or less.
If there are no signs of life, the person is unconscious. If more than one responder is present, have him call 911.
Traditional knowledge then directs the responder to administer chest compressions and mouth-to-mouth breaths.
This may only be half-correct.
"True mouth-to-mouth procedures are usually intended to be used on loved ones," Flores said. "We know dangerous diseases can be contracted from the saliva of others, such as hepatitis. We (as professionals) always use a breathing barrier when performing CPR so we are not physically touching a victim's mouth."
If first responders do not have breathing barriers, a hands-only approach with chest compressions is still highly recommended, Knopf said.
Victims must be positioned on a flat, rigid surface and have any shirts they are wearing removed, Knopf said.
Chest compressions are to be done via a 30/2 ratio; that is, for every 30 compressions, two one-second breaths are given.
Due to safety reasons and the improbability of people owning breathing barriers, breaths can be nixed from the process.
Knopf said "between the nipples and in the middle of the chest" - the location of the sternum - is the spot to compress.
The heel of the responder's hand should be placed in the center of the victim's chest, and the responder's other hand is then placed on top with fingers laced together, he said.
Responders' shoulders should be positioned directly over their hands, and when they push down, their hands should not come off the victim's chest - only their weight is to be leveraged.
"Compress about 2 inches for adults and 1-1 ½ inches for children," Flores said. "With infants, be very delicate and only use the padding of your two thumbs when compressing."
Children are classified as ages 1-8 years old and are treated as adults past the age of 8 when CPR is used, he said.
Once a person commits to helping a victim, they become vital to the victim's survival.
"Show willingness to respond to an emergency and once you do, don't stop helping," Flores said. "Good Samaritan laws are in place."
In this case, the Texas Good Samaritan Law protects bystanders from being sued if victims they help become injured or die. However, once bystanders commit to providing aid, they may be held liable if they do so in a negligent manner.
Implied consent is given by victims if they are unconscious that they need help.
Flores cautioned that performing CPR is a physically straining task coupled with an adrenaline jolt stemming from an emergency situation.
"If you've ever done CPR for just a few minutes, you're probably wiped out," he said. "You're constantly doing something - compressing, giving breaths or checking for signs of life."
Responders should not stop rendering aid, but they must safeguard their health by not overexerting themselves.
If an automated external defibrillator is present, remove it for professionals once they arrive, Knopf said.
On Randolph, CPR classes and certification are available. Call the base fire emergency services at 652-6915 for information. Visit the Red Cross website at www.redcross.org or the American Heart Association website at www.heart.org to access information on CPR.