Stayin’ alive with CPR

John Seth admits it wasn’t the aftereffects of his cardiac arrest that bothered him so much as the sore ribs he had after being revived by cardiopulmonary resuscitation.

Not that he’s complaining.

Better known by the acronym CPR, Seth is living proof of the benefits of learning the procedure, which has been made easier for those without training to perform.

The American Heart Association in Hawaii is using February — known nationwide as Heart Month — to spread the word about the simplified procedure for laypersons that emphasizes hands-only CPR. Gone is the mouth-to-mouth ventilation, the precise hand placement and the alternating cycles with chest compressions that may have discouraged bystanders from stepping in to revive stricken family, friends, co-workers or strangers.

Now the steps have been streamlined:

» 1. Make sure the person is unconscious by tapping or shaking his or her shoulder and loudly asking, "Are you OK?"

» 2. If the person doesn’t respond, get someone to call 911 and, if readily available, have someone bring back an AED (automated external defibrillator), which are commonly found in public places. The portable electronic devices provide audio and visual instructions for use.

» 3. In the meantime, place your hands, one on top of the other, directly over the person’s chest and immediately start compressions at a vigorous and continuous pace of 100 beats a minute, without pause until either the person comes to or additional help arrives. (For more complete instructions, see the accompanying information graphic.)

To make it easier to maintain the proper pace, hum along to the Bee Gees’ disco classic "Stayin’ Alive" and keep the beat with each compression. The American Heart Association adopted the tune as its CPR anthem at the suggestion of Dr. Alson Inaba, division head of pediatric emergency medicine at Kapiolani Medical Center for Women & Children.

And don’t worry about hurting the unconscious cardiac victim.

"For all practical purposes, that person is dead, so push harder than you think," said Dr. Libby Char, an emergency physician and Heart Association board member.

Board Chairwoman Pearl Whittaker said Hawaii has a "good Samaritan" law that provides liability protection to well-meaning, medically untrained people who try to help someone in an emergency situation.

"People don’t want to think, ‘Oh, my God, I broke some ribs.’ But what’s the alternative? That should be the least of your worries, and that person will thank you later for saving their life," Char said.

The change in procedures came after recent research by the Heart Association indicated that "breathless" CPR was more effective than including mouth-to-mouth breathing.

"The negative pressure, or sucking-in effect, created by the compressions — drawing in the blood from the brain, legs and arms into the heart — proved to be much more effective than the occasional positive pressure of blowing air into the lungs from the mouth-to-mouth," she said. "So it’s better just to do the chest compressions. The person still gets plenty enough oxygen during CPR until the advanced care arrives."

Folks who had CPR training years ago and are rusty should also use the hands-only procedure. For one reason, the sequence for the old "A-B-C" method (airway check, breathing and compressions) has been changed to "C-A-B" so that chest compressions are the first step, to reduce the delay in restoring blood circulation to the heart and brain.

Seth said he was fortunate he suffered his 1989 cardiac arrest while at the Queen’s Medical Center emergency room.

The insurance agent had walked back to his Bishop Street office from a breakfast meeting when he started feeling a cold sweat and chest pains. After calling his doctor to verify that he might be having a heart attack, Seth had his secretary call 911.

Even though he was conscious during the ambulance ride, Seth doesn’t remember what happened in the emergency room after he went into cardiac arrest and was brought back from the brink of death by CPR.

But he does recall that his ribs "were killing me when I regained consciousness after the CPR."

Seth, 76, now works as an American Heart Association volunteer and helps coordinate the annual Oahu Heart Walk fundraiser held in August. Close to 3,000 people participated last year and raised more than $260,000. This year the goal is $375,000.

Whittaker said the organization is hoping to train upward of 3,000 people in CPR by the end of the year with free classes and the sale and distribution of the Family & Friends CPR Anytime portable training kits. With the help of private donations and grants, kits are sometimes given out free of charge at classes. (They are also available for $34.95 at shop­cpr­any­time.org.)

Char said the "Mini Anne" learning manikin included in the kit "gives a little more realistic feel than the larger, standard one."

Whittaker said, "We think once people know how simple CPR is, they will be more apt to give it a try."

"With this little bit of knowledge, the impact is tremendous," added Char. "Think how empowering it is to feel that you can save a life, and that you can share that knowledge as well."

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To schedule CPR training sessions, call the American Heart Association at 538-7021 (244-7185 on Maui, 961-2825 on Hawaii island).