Bringing Back Dead : 40 Million in U.S. Trained in CPR

First aid used to consist mainly of mundane stuff such as wrapping bandages, improvising splints and applying ice packs.

But thanks to a discovery made 30 years ago by a group of doctors in Baltimore, it can now include something downright miraculous: bringing the clinically dead back to life.

And you don’t need elaborate, expensive equipment or years of medical school to do it. All it takes is a few hours of training and the presence of mind to act in an emergency.

The miracle is CPR: cardiopulmonary resuscitation. You may have seen Hawkeye Pierce and his “MASH” cohorts dramatizing the 1950s version on TV, thumping patients’ chests with their fists, then cutting them open to reach inside and massage their hearts to get them beating again. Not the sort of thing the average person could do.

In 1960, the Baltimore doctors realized that the heart could be massaged back into action through a closed chest, using the sternum, or breastbone, to compress the heart against the rib cage. It wasn’t until 13 years later that the American Heart Assn. identified CPR as a procedure that could be taught to the general public. Since then, more than 40 million people in the United States have been trained in the procedure, and thousands of lives have been saved.

Last Friday, at a class in CPR for passers-by, given at St. Jude Hospital and Rehabilitation Center in Fullerton, 21 new potential rescuers joined the crowd.

Passers-by are more likely to save lives with CPR than paramedics or doctors because they are more likely to be on the scene when an emergency occurs. Within four minutes after the heart stops beating, oxygen-starved brain cells begin to die off. After 10 minutes have passed, brain death is certain. No matter how prompt the call to 911, the damage may be done before help can arrive.

The definition of clinical death, according to the American Heart Assn., is when the heart has stopped beating and breathing has stopped. If clinical death is not reversed quickly, it becomes biological death and that is irreversible.

When preformed properly, CPR can produce 25% to 30% of normal blood flow to the brain--enough, in many cases, to keep the cells alive.

The survival rate for CPR begun in the first four minutes is nearly 30%, compared with only about 7% if it is initiated later.

Respiratory arrest, which can lead to cardiac arrest, can be caused by choking, drowning, electric shock, suffocation, smoke inhalation, drug overdoses, injuries, seizures, heart attacks and strokes, as well as by illness and allergic reactions, instructor Frieda Fox told the class. CPR can help with all but the last two causes, she said. For adults, heart attacks and strokes are the primary cause of cardiac and respiratory arrest.

If someone around you collapses, whatever the cause, or if you come across someone who has collapsed and doesn’t seem to be breathing, Fox says, the first step is to call for help. Don’t be afraid to shout if there is no one nearby. “You never know who might be around,” Fox said. “And if you are in a crowd, point to one person and say, ‘Call 911!’ Otherwise, they might all just stand around saying, ‘Wow! She knows how to do CPR!’ ”

Then administer CPR.

Don’t stop CPR for longer than 10 seconds unless the person revives, qualified help arrives (but keep at it until the paramedics take over), or until the person is pronounced dead by a doctor. “Or if you’re too tired or exhausted to continue, you can stop,” Fox said. “We don’t want you to become the second victim.”

If you do find a pulse after the first two breaths, maintain rescue breathing, administering one breath every five seconds, until help arrives or the person begins breathing regularly on his own. CPR can be messy. More often than not, Fox said, the victim will vomit, sometimes even without reviving. If that happens, clean out the mouth quickly and continue. You may break the person’s ribs. “If that happens, just reposition your hands and continue. You may lacerate the liver or puncture a lung, but those things are reversible. Death isn’t.”

After the advent of AIDS, CPR masks were developed to allow a rescuer to administer aid without exposure to body fluids. Small disposable masks that can fit into a pocket or purse are available, and Fox recommends that if you carry them, you might also want to include some disposable rubber gloves to use if you need to reach into the victim’s mouth.

“This is so much better than not knowing what to do in an emergency,” said Donna Harris of Westminster, one of the students in the St. Jude class. The group practiced on specially designed mannequins, and Harris said she found that particularly helpful. “It helps to practice,” she said. “It’s really different when you do it.”

CPR classes are available through the Orange County chapters of the American Heart Assn., the Red Cross, and St. Jude and other area hospitals.