At Get Lost Sailing all our skippers are first aid trained. It’s an essential part of our qualification to take passengers out to sea. One of the skills that is taught during all first aid courses is first aid CPR.
I recently taught a power boat course to some paramedics and the conversation over lunch naturally turned to the subject of first aid. (We’re always learning at Get Lost Sailing so we talk to the experts).
I learned a couple of new facts that the emergency services employ when determining the appropriate treatment for a casualty. So, this article is to raise awareness of the importance of basic first aid training concerning CPR.
FACT 1
If first aid CPR (or bystander CPR as the professionals call it) hasn’t been administered to a casualty within 15 minutes of a cardiac arrest then the emergency services will do nothing to revive that casualty. This is because the survival rate falls to 0%.
Fact 2
If the casualty has been immersed in a water filled environment such as the sea, that cut off time is extended to 45 minutes.
First aid CPR is defined as follows:
Cardiopulmonary resuscitation, commonly known as CPR, is an emergency procedure that combines chest compression often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
Why the 15 Minute Cut Off?
There are two main results of the actions within the CPR process. The two initial breaths into the casualty’s airway force air into the lungs so that there is a supply of oxygen being transferred to the blood stream. The following 30 chest compressions result in the repeated constriction and relaxation of the heart muscle. In other words they create an artificial heart beat. This heart beat pumps the oxygenated blood around the body and that is what preserves the brain function in the casualty.
When discussing the detail with the paramedics, they said that the chest compressions also force small amounts of air into and out of the lungs. This can be thought of as a form of shallow breathing. They then said, if somebody doesn’t know the full procedure, just do 600 chest compressions straight away.
Take a look at this graph that was produced by the Washington Department of Medical Education:
What this department modelled was the survival rate of casualties who received first aid CPR and defibrillation within certain timeframes. Public defibrillation machines are becoming more and more common place. In fact, our marina has two of them but still not everywhere will do. But there is always a chance of CPR being given.
The model started from the baseline that in a cardiac arrest situation only 50% of people will survive anyway, regardless of treatment. However, the remaining 50% have their chances massively increased if CPR is performed straight away. The graph clearly explains the paramedics cut off time too and shows they are being generous with 15 minutes.
You can read this model in detail here: survival model
Why the Difference in Water?
The paramedics also explained the reason for the extended time in water. Sudden immersion of the face in water causes the bodies metabolic rate to naturally and dramatically slow down. Therefore, the oxygen supply within the body is used up far more slowly and this extends the survival expectancy. Good news for sailors! Sort of…..
The point of all this is that if everybody were able to perform first aid CPR in these situations the survival rate of the remaining 50% would be increased. It would be a massive shame to lose a loved one or even a stranger just because nobody knew CPR. If you can get the time and can cover the cost, a basic first aid course will take a day to do and it is well worth it. If not, try and find somebody who knows how to do it and get them to show you. It’s a surprisingly fun thing to do and it really could make the difference one day.
Finally, take a look at the British Red Cross first aid app. It’s totally free and will give you loads of information for emergencies.
