CPR put to the test

SAVVY EDITOR Jodi Bryant, Conducting continuous chest compressions with 20-30kg downward force proved exhausting.

It's been over ten years since I underwent a CPR course and I have been intending to do a refresher. Still, I was fairly confident in my abilities when I was invited to put them to the test via a manikin which would assess my skills.

Known as Resusci Anne, the relatively new QCPR manikins is one of only a few in Northland to come with the latest technology that are now being used for training frontline ambulance staff.

St John - Northern Region acting district operations manager Wally Mitchell describes the manikins as excellent tools for coaching individuals on how to improve their technique in producing effective chest compressions.

"Chest compressions are now proven to be the most critical part of CPR when it comes to surviving out of hospital cardiac arrest with normal brain function," he explains. "The recent changes in CPR are resulting in more patients surviving to discharge from hospital with good outcomes."

I ask Wally if the ratio is still 30 compressions to two breaths, which he confirms. However, the focus today is on continuous chest compressions as a common mistake people make is not starting CPR early enough or not having the confidence to continue.

"People usually panic because they think they're not doing it right or they stop to make (emergency) phone calls, or they don't start CPR because they don't like the thought of having to do the breathing. My message as an intensive care paramedic is that doing something is better than nothing and, if you choose to only do chest compressions, then know how to do them well."

Chest compressions are exhausting, Wally tells me. An average adult chest requires between 20-30kg downward force to compress to the required 5-6cms. Ideally a person should continue for no more than two minutes but, if alone, it is recommended to carry on for as long as necessary.

And with that, I am put to the test. Although in real life, CPR would usually take much longer, the timer is set for one minute so I take my position and start pumping the chest. When one minute is up we wait for the screen to flash the result.

"12 per cent!"

This is tragic. Wally flicks through the device to see where I went wrong. Apparently, the rhythm was good, along with the hand position, but I just wasn't pushing down hard enough.

I sit the test again.

"Two percent!"

Wow. I am on a downward slide. It turns out my placement wasn't quite in the right spot and, still, I wasn't pressing down hard enough.

I ask Wally if he has enough time for me to nail this. A pass is 80 per cent but right now, things would be looking up for me at 13 per cent, although I'd really rather leave knowing I am capable of possibly saving someone's life.

I undertake another practice test, watching the screen as it corrects me. Finally, I am into a rhythm that seems to keep the machine happy. I'm ready for one last attempt.

I get into position - knees close to the torso, arms straight, and begin pressing up and down with gusto.

At between one and two thirds-two compressions per second (between 100 and 120 compressions per minute), Wally is right; this is exhausting! He points out that this manikin is also not a large torso and the larger the person, the harder one has to press. Finally, I stop and, not feeling too confident, look doubtfully at the screen.

"85 per cent!"

Phew! I feel like celebrating but tell Wally that, although I feel I would know what to do in an emergency situation, I'm not sure I would remember just how hard to press as it felt like I was doing some serious damage. He replies that broken ribs and bruises are secondary - saving the life is more important.

"If you step up and do something, you're giving the person a chance. If you do chest compressions 100 per cent effectively before emergency services arrive, you're definitely significantly increasing the patient's chances of having a good outcome. Considerable evidence now supports the concept that quality CPR ultimately, not only saves lives, it can also make a huge difference to the ongoing quality of the survivor's life."

Resusci Anne will be at the Summer Safety Day where members of the public can test their performance and be offered guidance.

For information about First Aid and CPR courses, visit: www.stjohn.org.nz