I recently completed my First Aid Course – first time in a while – and I wanted to hang on to the information I gathered. Basically, I run a motel frequented by a number of elderly guests, and I also have two elderly parents who could potentially at one stage or another be at risk of cardiac arrest.
Luckily, the folks at St John’s Ambulance have created a handy acronym for what to do in that crisis situation. The acronym is ‘DRS ABCD’, and it stands for Danger, Response, Send for Help, Airways, Breathing, CPR, then Defibrillator. It’s a nice step by step procedure to remember the steps around CPR.
Danger – Identify and clear all dangers in the surrounding area. Cardiac arrest doesn’t occur in a vacuum. There could well be broken glass, automobiles, electrical appliances, and other hazards still live. The steps you take to mitigate these hazards will depend on the context, but you can’t always put yourself at risk to perform CPR.
Response – Check the patient’s response by causing pain. This might involve punching their shoulder or shaking them roughly. For an infant, it means lifting them up and squeezing their toe firmly to check whether or not they are conscious.
Send for help – If you determine a patient is not conscious, immediately send for help. Sending for help is one of the most crucial stages, as this step will increase people’s survival chances under conditions of cardiac arrest from 5% to 15%. It’s important to make sure that the person who you send for help also informs you once that step has been completed, so that you know somebody has taken personal responsibility for the action and that help is on its way. Either call 111 or instruct someone to call for help and a debrillator and tell you once it’s done.
Airways – Open the mouth to check airways for any obstruction to a person’s airways. Tilt their head back to ensure that a person can breath without blockage from the tongue. If performing CPR on an infant, tilt their head only about half-way back.
Breathing – Position your ear next to the patient’s mouth. Looking down the length of their body, check whether or not they are breathing. Count 10 seconds – some people who are alive may not start breathing right away. Also note if the person is suffering ‘agonal’ or inconsistent breathing. If they are, proceed to perform CPR anyway.
CPR – With their nose pinched and your mouth fully covering their mouth, breathe into the persons lungs, then lift your head, inhale, and repeat. Apply 30 chest compressions to the patient. For an adult, use both hands, for a child, just one hand, and for an infant, use just two fingers. No matter whether it is an adult, child or infant, apply 30 compressions to each two breaths, and repeat until help arrives.
If they vomit, tilt them on side to drain the vomit. Then start DRSABCD again from the top.
Defibrillator – Apply a defibrillator if one is available. Defibrillators are designed to provide simple non-technical instructions once activated. They are very important because use of a defibrillator during cardiac arrest has been shown to improve a person’s survival rate from just 15% to over 40%.
One important thing to remember in performing CPR is that if a person has experienced cardiac arrest, then you cannot make the body any worse. Therefore do not be afraid to engage the body even to the point of potential further injury. Always ensure that you call for help as an early stage, even if this means leaving the body unattended for 20 minutes, because if you do not, CPR will be virtually impossible to sustain and the person’s chance of survival will be very low indeed.
