Resuscitation skills are necessary

Resuscitation skills are necessary

By Maria Endah Hulupi

JAKARTA (JP): Management of public facilities are required to
equip their officers with Cardiopulmonary Resuscitation (CPR)
skills to provide immediate treatment for cardiac arrest, a
cardiologist said.

Chairman of the Indonesian Health Society and Cardiologist
with the Department of Internal Medicine at the University of
Indonesia Y. Kisyanto said that cardiac arrests are still a major
health problem that can lead to sudden death.

However, the condition can be prevented if the unconscious
patient receives immediate CPR treatment on the spot.

In Indonesia, a number of cases of sudden death, which have
occurred in public places have been reported and many of those
people who didn't receive CPR treatment on the spot died before a
doctor arrived or before they were admitted to the nearest
hospital.

"In this case, CPR, is the patient's only chance of surviving
and must be conducted by people on the spot," Kisyanto said.

With the public's lack of awareness on this basic life support
skill, hotel management, airports, airline companies, malls,
police, firefighters, and other public buildings and facilities
must be given training on CPR procedure.

A prompt and proper application of CPR is required as the
critical period for cardiac arrest is only four minutes, thus it
gives one very little time to wait for the arrival of a doctor at
the scene, he warned.

Attempting to perform CPR after the four minute period may
still save the patient's life but will pose greater possibilities
of side effects, such as brain damage due to a deficiency of
blood and oxygen supply to the brain.

"If they survive the situation, the person will be feeble-
minded due to brain damage," he said.

People at high risks are those with coronary heart disease,
the elderly, smokers, diabetics, those suffering from
hypertension, those suffocating from heavy smoke, drowning, over
exercise, people who suffer severe dehydration due to intensely
high temperatures or those with extreme low temperatures and
those with deep vein thrombosis problem, whose blood clots have
reached the heart.

Prior to cardiac arrest, most people complain of pain in the
chest, breathing difficulties and in some cases, it can occur
very suddenly and the patients just fall unconscious during a
conversation or other activities.

"If the patient can still breath, it means that his heart is
still working. Give them some room to breath and immediately
contact a doctor for a professional opinion," he said.

Indications of cardiac arrest are unconsciousness, negligible
breathing after collapsing, having a weak pulse, pupil dilation
that fails to react to outside stimuli, such as shouting or
pinching.

"When this happens, someone at the scene should call a doctor
immediately but in the meantime another should start the CPR
procedure as basic life support to reactivate the heart,"
Kisyanto said.

The first thing one should do is lie the unconscious patient
on his back. One of the people at the scene must initiate the
blowing phase by placing a hand on the lower part of the
patient's breast bone or sternum, which is the location of the
heart and give a firm blow with an intensity of at least 15
kilograms on top of his own hand, using another hand.

Wait for awhile after the first blow, check if the patient
reacts, breaths or his pulse strengthens. If there are no signs
of improvement, repeat the same procedure for the second time.

If the patient remains unconscious after the second blow, the
procedure must be followed by gently lifting the person's chin to
clear the airway to enable respiration, giving "the kiss of life"
or artificial breathing and performing chest compressions, which
must be done in harmony with the normal heart rate of 60 to 70
beats per minute to reactivate the heart. The chest compressions
must be accompanied by artificial breathing every four counts.

Ideally this procedure is conducted by two people, one will
focus on chest compression and the other on giving artificial
breathing.

"Proper application of this procedure will help save the
patient's life, while waiting for the arrival of a better
equipped medic team, who will give better treatment for the
patient before they reach hospital," Kisyanto said.