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.