By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
I have a love/hate relationship with how healthcare is portrayed on TV and streaming programs. I love it because those mediums, with their broad reach, can bring so much awareness to important health and safety topics as part of a storyline on a program. The hate part comes in because sometimes the things they portray are incredibly inaccurate, which makes it hard when people come into the hospital with expectations based on what they saw on TV.
One of the things on TV that is incredibly inaccurate is Cardiopulmonary Resuscitation (CPR) and Automatic External Defibrillator (AED) use. The differences between TV and reality when it comes to CPR and AED use are huge. Last week I read an article that talks about how low the numbers are for bystander CPR and AED use, and it made me wonder if part of that isn’t because of the way those things are portrayed on TV. I’m hoping by talking about CPR and AED use, if you are ever in a situation as a bystander, I can give you confidence to step in and start CPR and use an AED when one is available.
According to an article recently published in the Journal of the American Medical Association (JAMA), despite legislation aimed at increasing the availability of AED’s in public spaces, bystander use of those devices and accompanying CPR remains low. In the study, the researchers looked at 9,290 cases of witnessed cardiac arrest at multiple recreational facilities that had an AEDs on site. In those cases, while 46.8% of those people would have benefitted from AED use prior to the arrival of emergency medical services, only 19% of people had an AED used. CPR was started by bystanders only 61.3% of the time.
One of the main reasons the researchers believe that people are reluctant to start CPR or use an AED is because they are worried they will hurt someone. I am going to be brutally honest here and tell you something that I tell people who are new to health care when they do CPR for the first time. If you don’t start CPR that person is going to die. If you start CPR, they have a chance to live. Even if they get injured by the CPR, they’re still alive.
Bystander CPR makes a huge difference in survival. When a bystander starts CPR immediately rather than waiting for emergency medical services, the person’s chances of survival triple! The other thing people worry about with CPR is mouth-to-mouth. We have learned that for bystanders, you just need to do chest compressions. This is called hands-only CPR. The American Heart Association has a great video on their website, https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr on how to do hands-only CPR. If you call 911, our wonderful dispatchers will also walk you through how to do hands-only CPR while you are on the phone with them.
On TV, people use paddle defibrillators and patients convulse after they are used, to me it always looks scary, painful, and quite frankly just awful. First, paddles are very old technology and rarely used anymore, even by healthcare professionals. An AED will not have paddles. We now use specially designed electrodes. The basically look like a square bandage made with thin foam on one side and a metallic finish on the other. The metallic side is sticky and goes against the skin on a person’s chest.
An AED will have pictures on the electrodes showing you exactly where to put them, and it will verbally walk you through every step of using the AED. The computer in the AED knows the times it will help and when it will hurt. You cannot hurt someone with an AED if you follow the directions it gives. The person might twitch a little, but they will not convulse like on TV.
An AED will defibrillate someone when it detects that the electrical system of a person’s heart has gone into pattern that does not allow the heart to beat in an organized fashion, which stops blood flow. Defibrillation acts almost like when you cycle the power on your computer, it resets it. That reset helps the heart beat in an organized way again and blood flow starts back up. Just like with CPR, the sooner we can use an AED the better. Survival increases significantly the sooner a person’s heart returns to an organized beat.
I hope you are thinking, “I’m willing to try, so where do I go from here?” First, while you don’t have to have a CPR card to do CPR, I still highly recommend that everyone take a CPR class. That way you can practice CPR and AED use before it’s an emergency. Both the American Heart Association and American Red Cross websites can direct you to live and on-line CPR classes.
If you can’t take a class, I highly recommend you watch the hands-only CPR video I spoke of earlier. Second, whenever you are in a public space, look for signs for AEDs. That way you know where to run to get one or where to direct someone to get one if someone near you stops breathing or having a heartbeat.
Finally, call 911 or get someone else to do so before you start CPR. You always want emergency medical services on their way to you as quickly as possible if you are ever in this situation., plus having that person on the line with you to coach is incredibly helpful as well.
I hope you never need to do CPR, but even more, I hope if you are in that situation, you feel a bit more confident about stepping in and helping. Performing CPR and using an AED are a way we can all save lives.
