WVAC 911: You can’t learn to save a life watching TV
Becoming an EMT has ruined TV for me. I used to be able to blissfully watch medical dramas, or eagerly sit on the edge of my seat as the hero would shock his partner back to life.
While we all know TV isn’t real, I find that people tend to believe a lot of the medical stuff. Caution, these are spoilers, and if you love medical dramas (or medical emergencies in dramas or actions), then you may not want to read on.
Spoiler alert No. 1
There’s no kissing in CPR.
The typical scene is a male or female who goes unconscious, and the object of his affection performs CPR (think Sandlot). The patient comes to as his rescuer is delivering mouth-to-mouth breaths, and they share a kiss, usually to the unpleasant surprise of the rescuer.
The active compression and release of the chest, both pumps the heart, and squeezes enough air in and out of the lungs to circulate oxygen to the heart and brain. High-quality chest compressions are done to a depth of two inches at rate of 100-120 per minute for adults. In the words of my EMT instructor, “you’re going to break some ribs with good CPR”.
When breaths are delivered by EMS, it will typically be done through a Bag Valve Mask (BVM) or through a pocket mask rather than mouth to mouth. Both devices protect the rescuers from contamination and help ensure air is delivered more effectively and efficiently to the patient.
In other words, there is nothing romantic about it!
Spoiler alert No. 2
You can’t breathe without an open and clear airway.
On TV, people immediately start CPR and mouth-to-mouth; however, they almost never take an essential first step, which is to ensure the airway is open and clear. Most of us learned in a basic CPR course that we took in school or in lifeguard training about the “head-tilt/chin-lift” maneuver. It is challenging to maintain the position to adequately deliver breaths. On TV, the actors typically just open the mouth.
Also, on TV, the patient has typically lost consciousness and stopped breathing because he or she was in an accident or fall. When trauma is involved, with a suspected head, neck or spinal injury, we never use the head-tilt /chin-lift because we must protect the cervical spine (neck) from further injury. Instead, a jaw-thrust maneuver is used. Lastly, when performing CPR and delivering breaths, it is essential to maintain the airway using an oral airway (OPA) or a nasal airway (NPA). This is something that is practically never seen on TV. You may see more advanced airways, such as endotracheal intubation, being simulated; however, it’s never as clean or easy as it is on TV.
Spoiler alert No. 3
You can’t shock someone who is flatlining back to life.
Countless times on TV, movies, cartoons, or even in plays, you see actors pretending to shock a patient back to life. Usually in the medical dramas they are using paddles that they rub together before yelling “clear.” After a couple of dramatic shocks, as they watch the flatline on the screen for a blip, the patient’s heart miraculously starts beating again.
First and foremost, the shock doesn’t start the heart; it stops it in an attempt to disrupt certain chaotic and disorganized heart arrhythmias and reset it back to a normal beating rhythm. A heart in “flatline” or asystole cannot be shocked back to life. Only quality CPR and epinephrine can do that. The device used to deliver a shock is called a defibrillator. A shock is delivered to a patient without a pulse when the heart is fibrillating or twitching with very rapid irregular contractions. An AED or Automatic External Defibrillator is used by EMTs in the field to detect and shock a fibrillating heart, and it may be used by any bystander as well. The AED comes in a small box or case with chest pads (for adults and children), and should be found in many public spaces.
In a scenario where someone collapses from sudden cardiac arrest, the rescuer should immediately request someone bring an AED while he or she performs chest compressions. Lastly, the rescuer should only stop compressions while the machine analyzes, and when the shock is being delivered. Compressions should always be immediately resumed following delivery of a shock. No dramatic waiting and looking at a machine.
Spoiler alert No. 4
You can’t learn to save a life watching TV
Most of us don’t like to think of having to perform CPR in an emergency, especially on a loved one. You may think you can rely on a vague memory of training you’ve had in the past in combination with your knowledge from avid TV watching. However, the best way to give the best care to a patient in cardiac arrest is to keep your skills and training sharp and current. If you are interested in learning how to perform CPR and correctly use and AED, please contact WVAC. You’ll learn how to do high-quality chest compressions, and how to use an AED. It doesn’t take long, and you could save a life.