Bystanders can be lifesavers – our September meeting
A heart sign with our hands: trickier than it looks! It's a sign of support for the national WI campaign Bystanders can be Lifesavers.
We were very lucky to have the knowledge and real life experience of our president, Sally, a breast cancer nurse, for an evening learning the basics of cardiac massage and defibrillator use.
Sally started by introducing our inflatable 'patient' for the evening... and the WI campaign. The theory is that even if you don't feel physically able to do it – cardiac massage is exhausting and in a healthcare setting, done in relays – you can instruct somebody else.
There are around 30,000 out-of-hospital cardiac arrests per year. The recovery rate is very low: about 7% survive against 27-28% in hospital.
Sally talked us through what a cardiac arrest is: a problem with the electrical impulses in the heart. Anyone who has had a cardiac arrest is likely to be unconscious and probably not breathing.
What holds people back from doing cardiac massage?
"Am I going to hurt them?" is often the biggest worry. Sally explained that you can't make them any worse than they are. Yes, we would probably break ribs but breaking the sternum would be much less likely. There's fear of legal action but it's obvious that someone has been in dire need. Fewer people are prepared to try and resuscitate a woman than a man because they're worried about taking a bra off (for defibrillator use, metal is best removed so belts and jewellery should be taken off too).
During the pandemic, mouth-to-mouth resuscitation was phased out, because of infection risk and advances in knowledge, that the most helpful thing is to keep the heart pumping.
Sally took us through the main steps:
First, talk to the person. If no response, squeeze the top of the shoulders. Having ascertained that the person is not well and needs some help:
Shout out for help. You, or they, call 999 and ask for an ambulance. The first thing the ambulance service will ask is, "Is the patent breathing?"
Tell them where you are. They give you the address and code for the nearest defibrillator that's registered with the ambulance service. There is also a website, The Circuit, which tells you where the nearest defibrillator is.
A lot of defibrillators are in settings such as schools and care homes where they are not accessible to the public. There is pressure at the moment to make them accessible. Stations have them – Waterloo has 100 – and most fire stations. Each defibrillator has a guardian, who does the upkeep and registers it with the ambulance service. But where they are, how accessible and which are registered is very patchy.
Back to the steps: once on to 999 with someone collecting a defibrillator, the best next thing is to start cardiac massage. It can be helpful to have your phone on speaker so that the ambulance service can talk you through what you need to do.
Sally demonstrated the best hand positions for cardiac massage, on adults and on children, the speed – 120 to the minute – and depth of 6cm.
Then, with our dummy defibrillator, which has all of the equipment but no electrical charge, Sally took us through how to use it and the importance of keeping people clear while it's shocking. The reusable pads, for adults and children, had diagrams of where to place them, and the machine talked us through as it analysed the heart rhythm, shocked, then if no rhythm, told us to resume heart massage.
Sally explained that if there is no defibrillator, or you are alone, you just keep going with cardiac massage as long as you can. But "You're not quite as alone as you think you are" – the ambulance service would stay on the line, we should feed back to them and they would tell us when it's safe to stop.
There was chat about the messiness of a real situation. That the person is likely to have poor colour with ashen skin, they may have been sick, they might be slumped in a chair and need to be got onto the floor, or need to be rolled onto their back. And then there are hairy chests. which can be hard to stick defibrillator pads to – there are razors in defibrillator packs now.
Sally told us how sophisticated training dummies are now in hospitals, even programmable with different heart rhythms.
Some of us had a go at cardiac massage and role playing the things we needed to do.
How would we know it's worked? Sally explained that people do cough and splutter, then you know they're better again.
And what next? A lot of people go back into the community without enough knowledge of what they've experienced, so cardiac rehab is becoming available.
Sally's closing tip: "It's quite easy to forget to ask for help."
A massive thank-you to Sally for an interesting and engaging evening full of practical information and advice. And a special mention for our 'patient', who's welcome at a meeting any time, even if she was looking somewhat deflated at the end of the evening...
Our monthly coffee morning and meet-up: Clarnico Club
Friday 26th September 10.30-11.00, Clarnico Club, 1 Tandy Place, E20 3AS, opposite V&A East Storehouse
388 bus, a five minute walk from Hackney Wick station (Mildmay Line), or from Stratford International DLR, a walk across the Olympic Park.
