Cardio-Pulmonary Resuscitation

This month we take a look at Cardio-Pulmonary Resuscitation.

On Saturday, viewers across Europe sat in shock as they witnessed the horrifying scenes occurring on a football pitch in Denmark during the delayed Euro 2020 football tournament.

Danish football player, Christian Eriksen, collapsed on the football pitch 5 minutes before half time, with no interaction with another player.

What saved Christian Eriksen?

The simplest answer to this important question is TIME.

Within 5 seconds of his collapse English referee Anthony Taylor had blew his whistle to stop the game and waved the medical staff onto the pitch. During this time the Danish captain, Simon Kjaer had opened the airway, and his quick action started the process of saving the life of his compatriot.

How do you open the airway?

In order to open the airway of the casualty:

  1. Place your hand on the forehead of the casualty and gently tilt the head back,
  2. Using your fingertips, lift the chin to open the airway.

Not only did Kjaer open the stricken football star’s airway, but he also commenced Cardio-Pulmonary Resuscitation (CPR) before the medical staff reached him. This quick thinking and action potentially saved Eriksen’s life.

How to do CPR

The skill of Cardio-Pulmonary Resuscitation is a very simple skill to learn and carry out. We would recommend training in this skill in order to provide confidence however the steps to save a life are:

  • Kneel by the side of the casualty,
  • Place the heel of one hand in the centre of the chest, place your other hand on top and inter-lock your fingers,
  • Keep your arms straight and position yourself vertically above the casualty’s chest,
  • Press down on the sternum to 5 to 6 cm (1/3 of the chest cavity)
  • Release the pressure without losing contact between your hands and their chest,
  • Repeat 30 chest compressions at the rate of 100 to 120 per minute. (If doing rescue breaths)
  • Pinch the soft part of the nose closed, allow the mouth to open, but do maintain chin lift,
  • Take a normal breath and seal your lips around the casualty’s mouth,
  • Blow steadily into the mouth, while watching for the chest to rise, take about 1 second,
  • Keep the airway open, removing your mouth away from the casualty and watch the chest fall as the air comes out,
  • Repeat to give a second rescue breath,
  • Return your hands to the chest of the casualty and give a further 30 chest compressions,
  • Continue at the rate of 30 chest compressions to 2 rescue breaths.

Remember that while we in the current Covid-19 pandemic, advice for rescue breaths focus’ on whether you are comfortable to provide the rescue breaths. This is likely to be if you know the person well, e.g., a family member. If you are not providing rescue breaths to your casualty then you should complete chest compressions at the rate of 120 per minute continuously.

Once the medical staff arrived at the far side of the pitch and therefore the side of Eriksen, they quickly assessed him and applied an Automated External Defibrillator, in order to provide a shock to his heart.

How to use an Automated External Defibrillator (AED)

If you have a second first aider, ask them to continue CPR while you set the AED up.

  • Switch on the AED and follow the voice prompts,
  • If they have a wet body, you will need to dry them for the pads to stick, if they have a hairy chest you will need to shave the pad area.
  • Attach the pads to the casualty’s bare chest:
    • 1 below the casualty’s right collarbone,
    • The other over the lower ribs on the left side.
  • DO NOT peel the pads of the chest if you have placed them the wrong way round, the Defibrillator will still work,
  • While the AED analyses the rhythm – stop CPR and ensure that no one touches the casualty,

If a shock is advised

  • Make sure that nobody is touching the casualty,
  • Push the shock button as directed, (remember fully automated Defibrillators will shock automatically),
  • Once the shock has been delivered, recommence CPR at a ratio of 30:2 (or 120 per minute if not rescue breathing),
  • Continue as directed by the voice/visual prompts of the defibrillator.

If a shock is not advised

  • Continue CPR at the rate of 30:2 (Or 120 per minute if not doing CPR),
  • Continue as directed by the voice/visual prompts of the defibrillator.

Once the medical staff had stabilised Christian Eriksen he was placed onto a stretcher trolley and transferred to the local hospital for further examination and medical care.

The process that was followed by the medical staff, referee and Denmark Captain highlights the importance of the Chain of Survival which we teach on our first aid courses.

What is the Chain of Survival?

The Chain of Survival is a chain of 4 links that provide the casualty with the best possible chance of survival. Remember that for every minute delay in using a defibrillator on a casualty diminishes the chances of survival by 10%. However, it is important to say that if you are alone, forget about getting a Defibrillator until help arrives as the most important thing you can do on your own is commence CPR.

The Chain of Survival consists of:

  1. Early recognition and call for help,
  2. Early Cardio-Pulmonary Resuscitation,
  3. Early defibrillation,
  4. Post resuscitation care.

When do I stop CPR?

There are 4 reasons to stop CPR, these are:

  1. The casualty has started breathing (keep an eye on them as they may stop breathing again!),
  2. The Paramedics have arrived and tell you to stop,
  3. A second first aider takes over (preferably every 2 minutes),
  4. You are too tired and have to stop.

Christian Eriksen Update

Over the last few days, updates have been coming out on the condition of Christian Eriksen, showing that he is on the road to recovery. What the future holds for him at this stage is not yet known, but the important thing to say is that he is alive and that is completely the most important thing.

As we write this article this morning, an image of Christian Eriksen sitting up in a hospital bed with him holding his hand in a thumbs up position is being circulated on the internet and news outlets.

We want to wish Christian Eriksen
A good recovery and wish him well for his future.

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