Winston Henry, CPR supervisor, the Heart Foundation of Jamaica, demonstrates the automated external defibrillator (AED) on a patient model (a dummy) 'experiencing cardiac arrest'. - JUNIOR DOWIE/STAFF PHOTOGRAPHER
Would you know what to do if someone collapses in your presence? He could be suffering from heart or respiratory problems, and actions taken in the interval between collapse and defibrillation (administration of a shock to the heart) will determine the patient's survival.
TO INCREASE people's survival chances the Heart Foundation of Jamaica (HFJ) has been, for many years, training community and health personnel in cardiopulmonary resuscitation (CPR) and first aid.
Winston Henry is the Heart Foundation's CPR supervisor. He said that if a person collapses, the trained personnel will go through the ABC protocol even if an automated external defibrillator (AED) is available. The AED is a small machine, very user-friendly, with voice-activated instructions, so anyone can use it, in cases of cardiac arrest.
"A person must be unresponsive, not breathing and have no circulation before the AED is applied to them," said Mr. Henry. "And how would I know that? I would have to go through the ABCs of CPR."
ABCs
The ABCs stand for airway, breathing and circulation. Mr. Martin explained that he would open the airways, check for breathing and looking, listening and feeling as he assesses pulse and breath sounds. He would do this ABC protocol after first calling the emergency number for help and tapping the patient's shoulder and asking if he is OK.
If there is no response then he pinches the patient's nose and administers two breaths, then check for a pulse. It may be time to reach for the AED machine.
"It's not every person who collapses who will need ventricular defibrillation ... if the heart is quivering the machine will instruct you to administer a shock, but if the person's (heart has stopped beating) then the machine will issue a no shock advice. I will then do my chest compressions, (afterwards) the machine chips in, analysing heart rhythm," he said.
He would do a cycle of four sets of15 chest compressions followed by two breaths. Deborah Chen, HFJ's executive director, explained that this protocol is currently under review with the recommendation being 30 compressions to two breaths.
The AED is preferably placed at the patient's left ear, following the machine's instructions, one pad is placed at the patient's sternum (the breastbone) and the other one below the armpit, about the fourth to fifth intercostal region, Mr. Martin explained.
The AED machine gives instructions such as "analysing heart rhythm. Do not touch the patient". Mr. Martin said that it was important to ask persons to stand clear of the patient before delivering the shocks, or else the shock may shock them and they could fall to the ground.
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