By Dr. Tom Gross
Marin Independent Journal (California)
Copyright 2007 Marin Independent Journal, a MediaNews Group publication
All Rights Reserved
Editor’s note: Dr. Tom Gross is the emergency medical services director for the Novato Fire Protection District. His column appears every Monday in the Marin Independent Journal. His views do not necessarily reflect the views of JEMS.
The recent news of the dramatic rescue of a Novato toddler at the bottom of a pool hit the major news services on an otherwise slow news day, but the real news is hidden between the lines.
We have been experiencing an increasing percentage of successful resuscitations from cardiac arrest, and I have come to the conclusion that one of the major factors in our success is not only the expertise of the paramedics and EMTs on scene but also the widespread community expertise in cardiopulmonary resuscitation or CPR.
Medical research has clearly demonstrated that in order to improve the already marginal chances of a successful outcome in the setting of a cardiac arrest, CPR must be started within four minutes of cardiac standstill. Advanced Life Support (ALS) measures, such as a defibrillating electrical current or specific cardiac medications, must be applied by paramedics or emergency personnel within eight minutes.
However, these ALS measures have little or no chance of success if CPR has not been started earlier, as noted above.
Even in the best of circumstances, the odds of survival after cardiac arrest, without any neurological impairment, are never good and occur at best only 50 percent of the time. In the absence of timely CPR, survival is unlikely.
Recently there has been a large increase in the number of people trained in CPR. Novato Fire Protection District trained 425 people last year. CPR is being taught is the schools, and there are more reports of children providing lifesaving CPR to other children. Many businesses provide CPR classes for their employees.
Given the potential benefit, it makes you wonder why everybody is not certified to provide CPR.
Some people are concerned that, if they become certified in CPR, they are required to act. Not true. Certification in CPR does not confer upon a person a “duty to treat.” The training just gives a person the skills with which to act should he choose to do so.
Others worry about liability. Good Samaritan laws exist to protect the volunteer and to encourage people that they can provide lifesaving measures without fear of legal repercussion if the outcomes are not ideal. Others are concerned about their risk of contagious disease such as AIDS or hepatitis.
Current CPR classes teach techniques that can improve a patient’s chance of survival without increasing the risk to the CPR provider. Additionally, many CPR courses provide, upon successful conclusion of the course, barrier masks for voluntary rescue breathing that protect the CPR provider.
The toddler who fell into the pool last week is alive today because of rapid intervention; the removal of the child from the water followed by the immediate initiation of lifesaving CPR.
It should serve as a reminder that CPR classes are available through many agencies, including many fire departments. So many courses exist that one can be found to suit almost anyone’s schedule, whether in the evenings, days or weekends.
If courses at your local fire department do not meet your schedule, someone can get you in touch with other courses in the county.
It can be so agonizing to stand at the scene of an emergency and to feel totally helpless, doing nothing as the sirens in the distance approach painfully slowly. Training in CPR will help you to keep your head and to take the proper actions in the proper order while you wait for paramedics to arrive.
Please consider taking a CPR class. As we all learned last week, sometimes it makes all the difference.