CPR - personal lesson learned

[wstorms]

Although not a diving incident, I wanted to share this anyway, maybe it benefits somebody. It is a personal story of a tragic event, I will try to write it as factual as I can.

As an EFR instructor, I signed up to volunteer at a service (in the Netherlands, "HartslagNu") that sends out an alert to first aid responders when the EMS are called. When the EMS dispatches an ambulance to an address nearby, and suspects CPR is needed, I (and other volunteers like me) get an automated text and call with the details. The idea is you go out, provide CPR as needed and hand over to the professionals.

This morning I got a call and went over. Another responder was already there, ambulance on the way. We provided CPR (including rescue breaths) until the ambulance arrived. The medics took over, but stopped after a few minutes and some thorough testing. The patient was dead and had been for a while.

For me this was the first time when I provided CPR in actual real live instead of training. Although it was unpleasant, I am still glad that I did. Maybe some day I need it myself, and I like to think somebody would do if for me.

However, I did provide CPR without personal protection. Not a good idea during these corona times. In hindsight, I did know to provide chest compresions only, but in the moment, I did not remember and provided rescue breaths as well. It stressed me out quite a bit. What if I got corona because of it? Or what if it was something completely different? What would it mean for me and my wife?

Back at home I showered, brushed my teeth for 20 minutes and cleaned the bathroom with bleach after all that. It doesn't really matter much, but it did help my own state of mind.

My wife is really supportive, and it really helped talking about it with her. I am still a bit shaken, but will be fine.
A moment ago I got a call from the police. The lab determined the cause of death was an overdose, no sign of any sickness, including corona. Although tragic, I can't help but feel some (selfish?) relief.

All in all I will be fine, but wanted to share this in the hope that it might help somebody in some form. The lesson learned (and repeated by the professionals):

If you don't have protection available, do not provide rescue breaths but only provide chest compressions.

 

[Panther1880]

Well, the first thing is always that the situation should be safe to you too. There's no point in having two dead bodies. So caring for your own life is nothing to be ashamed of. It's even in procedures.
I have great respect for you!
I do follow training yearly but I can't see myself doing this too much. If I end up in a situation where it's needed I'll provide it but being on the texting list is a bridge too far for me. I don't think I can handle it mentally.

 

[Ukmc]

Not to add to your anxiety, but there are worse things than corona that you can contract from giving mouth to mouth. Most people learn CPR but never have to do it. This system that you are describing is very interesting and helpful however substantially increases the chances of you needing to provide CPR. I would invest in a CPR mask or uni-directional CPR valve (both are really cheap and some pocket friendly).

 

[wstorms]

I would invest in a CPR mask or uni-directional CPR valve (both are really cheap and some pocket friendly).

Yup, that's kinda my point. The stupid thing is:
- I know I should mind my own safety first (I even teach this)
- I do have personal protection masks in my dive box in the garage
- I have read the advise to only provide chest compressions now (although you are right there are other bugs you can catch, the local advise over here seems to be based on corona uncertainty based on the thinking that if somebody dies because of corona, they will have a huge viral load), I have read it several times, the first time several weeks ago.

And yet, despite all that I acted differently. Call it muscle memory or autopilot, call it stress, lack of situational awareness at the time or whatever you want. It happened. So my main reason for sharing is that I hope it doesn't happen to anybody else.

For me, I am thinking about putting up a shelve next to the coat rack so I can put the first aid kit with personal protection stuff right there in sight.

 

[-JD-]

First, thank you for serving you community, and I wish you continued health.

Since you are acting as an on-call stop-gap first responder, might you consider having your organization upgrade your training to the use of bag-valve-masks for ventilation? They are available quite inexpensively.

 

[wstorms]

First, thank you for serving you community, and I wish you continued health.

Since you are acting as an on-call stop-gap first responder, might you consider having your organization upgrade your training to the use of bag-valve-masks for ventilation? They are available quite inexpensively.

yes, but for me, this is not about learning additional skills or boosting knowledge on a conscious level, but rather about availability in the moment and adapting the training and theory to the actual real life circumstances. That is the biggest lesson learned (hopefully) for me.

 

[uncfnp]

I can not express the admiration I have for your willingness to do this for others. First responders risk the same exposures and mental trauma faced by more traditional providers but often without the same support system. I tip my hat to you and say “Thank you.”

Unexpected CPR can happen to any of us then its a personal choice whether or not to provide respirations without protection. As a first responder you should keep a small bag of gear handy, many keep it in their car. But during this covid crisis I am not certain even the one way valve on a CPR mask would provide adequate protection.

 

[Bowers]

Thank you for being the kind of person to step up when the need exists.
As a paramedic i always carry a very basic med kit in my car in case i get caught up in helping someone when im off duty. It’s not an extravagant kit, but does include a bag valve mask. If you’re signed up to get notifications to help with local calls, i would consider having a small kit handy in your car and not just somewhere in the garage.

 

[PoolsOpen]

Thank you for stepping up and volunteering

Like others have said, I also strongly recommend getting some basic personal protective equipment. Since you are on call, perhaps the local ambulance / fire station can provide you with the equipment?

Minimum would be : gloves, face mask, eye protection, ambu (bag valve mask), alcohol foam or some disinfectact to wash hands.

In my opinion, all of these should be provided to you at no cost.

Also be careful,
as a firefighter / Paramedic I've been on scenes more than once where the call came in as medical, but it turned out to be homicide with the subject still on scene.

If you show up alone , it could be a problem...

 

[CuriousRambler]

I think your experiences, and emotions, are more common than not. The urgency of these situations often overwhelm folks, especially if it's one of your first exposures to such things. Forgetting protective equipment is incredibly common, and at least in the US, I've noticed recurrent training becoming more and more focused on protective equipment as a result.

It's a small comment in your overall story, but I'd like to comment on one point specifically:

The lab determined the cause of death was an overdose, no sign of any sickness, including corona. Although tragic, I can't help but feel some (selfish?) relief.

This type of feeling is exactly the normal, and appropriate response. It's easy to feel guilty for being relieved at your own well-being, when other lives were lost. It's important to remember that your well-being has, and had no bearing on the outcome of those other lives. Feeling relief that you're not at risk going forward in no way means you did anything wrong, and it certainly doesn't imply you're somehow being insensitive toward the patient. Try not to let this bother you, it really is normal.

I've found it helps me to mentally stop myself completely when approaching these situations. Stop, take a couple of deep breaths, and take a moment to just look around and get your bearings. It winds up being only a couple of seconds, but is enough to break that "rushing through it" mindset. Not only does it prevent me from putting myself in a bad situation, but it slows me down enough to not be shaking if I'm trying to write notes, and to remember things like checking the time, etc. Like you, I don't do this stuff full time. Ideally, I never do it again haha. It's easy to be overwhelmed and miss details. You do get used to it, and learn to manage the stress, but my experience has been that you can just as easily get "un-used to it" if you go a long period without those kinds of stressful exposures.

Also be careful, as a firefighter / Paramedic I've been on scenes more than once where the call came in as a medical, but it turned out to be a homicide with the subject still on scene.

I almost made a similar comment, but decided not to. The most unprotected exposure to blood I've ever had was while I was approaching a scene and unknowingly came face-to-face with the attacker, whose hands were covered in blood. He grabbed me by the elbows and started pushing me around. I broke his grasp, and responded how you might expect somebody to respond to being grabbed by a stranger, at which point he decided to run away. I didn't realize until quite a bit later that his hands had been covered in the victim's blood, which he effectively wiped off onto my bare arms.

There are all kinds of dangers, try to be as alert as possible from the moment you get that call.