Have you ever done CPR? Not on a manikin but on a real person. It requires quite an effort. It also is a good exercise – it involves multiple muscle groups: arms, shoulders, back and even abs. I am surprised they don’t have it as a workout technique, something like TotalCPR or TurboCPR. The idea is to push against the chest wall elastic recoil and pump the blood out of the heart in an effort to preserve blood supply to the vitals organs. Providing rescue breaths used to be a part of CPR. That did not work very well in a community. Imagine that you have to wrap your lips over dead stranger’s mouth and blow air into his lungs. Not to mention that the person could have a communicable disease and a questionable oral hygiene. It has been changed recently – just chest compressions are good enough. Rescue breaths were not found to be ”effective” anyway and provider willingness to do it was a “concern”. No kidding!

Does CPR work? Yes it does. Like any good medicine it can save lives when used in the right circumstances. Imagine 50 or so year old gentlemen golfing with his friends and, suddenly, collapses. CPR initiated by his buddies. EMS arrives within minutes. The patient is being defibrillated by the Automated Defibrillator and transferred to the Hospital. He is taken to the Cath lab where cardiologist opens up one of his coronary arteries. The patient recovers completely and doesn’t even remember anything – like it never even happened. This is very good. This is how it is supposed to be.

Now, imagine you have to do CPR on a 94 year old female with bones as thin as paper. The sound of breaking bones makes you cringe. Then CPR becomes a bad medicine, causing more harm and suffering to the patient. Patients do develop complications from CPR. Broken ribs, broken chest bone or even pneumothorax (air in a chest) can and do happen. The image above demonstrates a pneumothorax after CPR. In this case it was likely caused by an inadvertent initial insertion of the breathing tube too far into the right lung. This could literally blow the lung. Should have this patient gotten CPR in the first place is more an ethical issue and we will have to come back to it later. For now lets stick to the technical aspects of it.

We live in the age of major breakthroughs in healthcare. Is there a better way to provide this potentially life- saving treatment? Actually, there is. There is an anecdote of successful resuscitation by using a toilet plunger. It does make a perfect sense. You are not only squeezing the blood out of the heart by pushing on the chest you are also pulling the chest wall upwards, creating negative pressure and improving venous return to the heart. There is a patented device to perform CPR with. It has two handles for better grip; otherwise, it looks just like a plunger. It the real life, I am not sure how practical it could be. The patient’s size could vary greatly, so you will need multiple sizes of this device. I can see myself walking into the patient room and asking for a “medium plunger with number 3 suction cup”.

There is also a mechanical CPR device called LUCAS CPR. I saw a demonstration of this device on a manikin. It looks…, lets say vigorous. I have never tried it in real life. My concern, though, is how long it will take to apply this device in the real life cardiac arrest. The scene of cardiac arrest could be quite chaotic. Sometimes, I literally have to kick spectators out of the room before we can start CPR. If somebody has used this device in real life – let me know.

Otherwise, sorry for the long post, I will try to keep it shorter next time.
See you around.