Have you ever sorta wondered about something and then had it laid out to you full force? I had that experience today, and it was an eye-opener.
I attended a first aid course today. I've done them in the past, but I haven't done one for a very long time. I learned everything from burn treatment to wound treatment to a slight cough treatment. My instructor, Gus, was great. When he's not teaching first aid classes he's a paramedic in Toronto.
The real meat and potatoes was the CPR portion of the class. That's the chest compressions and mouth to mouth stuff you see on Baywatch (the cool kids are hip to that now, right?).
Anyways, back when I was watching M.A.S.H. in the late 1930's, something always struck me as odd about chest compressions. I heard rumours about what I was thinking, but I've never had it laid out for me in such black and white terms until today.
Chest compressions aren't effective unless you compress the ribcage 4" (for adults). You have to get right down to where the heart is, and it's protected by all kinds of layers of junk. 4" is a lot, and you have to do this repeatedly. 60 chest compressions per minute until EMS arrives. The average EMS response time where I live is 8 minutes, so that's like, um, a BUNCH of repeated 4" chest compressions.
I think you can see where I'm going with this. If you compress a ribcage 4" multiple times, something has to give.
I asked Gus point-blank about this, and he gave a great answer.
Effective life-saving chest compressions will break ribs. If you don't break ribs, the chest compressions won't be as effective as deeper compressions that do break ribs. Gus gave me some statistics - 77% of people that did not have their ribs broken during CPR while suffering from cardiac arrest had some form of permanent brain damage; 80% of people that did have ribs broken during CPR made a complete recovery. Gus said that these figures came from a study that entailed 65,000 CPR patients (that survived, of course).
Remember some of those old medical TV shows that had a guy making a double fist over his head and slamming it into a cardiac arrest patient's chest? That wasn't meant to kick-start a heart (CPR is only 2% effective in restarting an arrested heart anyways, and isn't the point of it); it was meant to break the ribcage before effective chest compressions could be performed. They used to teach that as a part of CPR back in the old days (it is NOT recommended now).
My mind is enlightened. I take no responsibility as to the veracity of the exact figures in my post, but I have confidence in Gus.
edit: I really mucked things up but I fixed them
I attended a first aid course today. I've done them in the past, but I haven't done one for a very long time. I learned everything from burn treatment to wound treatment to a slight cough treatment. My instructor, Gus, was great. When he's not teaching first aid classes he's a paramedic in Toronto.
The real meat and potatoes was the CPR portion of the class. That's the chest compressions and mouth to mouth stuff you see on Baywatch (the cool kids are hip to that now, right?).
Anyways, back when I was watching M.A.S.H. in the late 1930's, something always struck me as odd about chest compressions. I heard rumours about what I was thinking, but I've never had it laid out for me in such black and white terms until today.
Chest compressions aren't effective unless you compress the ribcage 4" (for adults). You have to get right down to where the heart is, and it's protected by all kinds of layers of junk. 4" is a lot, and you have to do this repeatedly. 60 chest compressions per minute until EMS arrives. The average EMS response time where I live is 8 minutes, so that's like, um, a BUNCH of repeated 4" chest compressions.
I think you can see where I'm going with this. If you compress a ribcage 4" multiple times, something has to give.
I asked Gus point-blank about this, and he gave a great answer.
Effective life-saving chest compressions will break ribs. If you don't break ribs, the chest compressions won't be as effective as deeper compressions that do break ribs. Gus gave me some statistics - 77% of people that did not have their ribs broken during CPR while suffering from cardiac arrest had some form of permanent brain damage; 80% of people that did have ribs broken during CPR made a complete recovery. Gus said that these figures came from a study that entailed 65,000 CPR patients (that survived, of course).
Remember some of those old medical TV shows that had a guy making a double fist over his head and slamming it into a cardiac arrest patient's chest? That wasn't meant to kick-start a heart (CPR is only 2% effective in restarting an arrested heart anyways, and isn't the point of it); it was meant to break the ribcage before effective chest compressions could be performed. They used to teach that as a part of CPR back in the old days (it is NOT recommended now).
My mind is enlightened. I take no responsibility as to the veracity of the exact figures in my post, but I have confidence in Gus.
edit: I really mucked things up but I fixed them