I just did CPR and….*
Your Defibshop is supportive and here to help with any questions you might have following your involvement in assisting with a Sudden Cardiac Arrest. Have you just assisted with SCA first aid? Are there some questions you now have? Are you worried about how you might have performed? You are not the only one who is wondering how you went, we get lots of questions from others after using their defib to render SCA first aid. Let us put you at ease with some answers to your questions:
- Sounded like ribs breaking: You may well be correct. Part of performing life saving resuscitation involves doing ‘cardiac compressions’ on the patients chest. The recommended depth of compressions, as a guide is about 1/3 the depth of the patients chest. Depending on the size and build of the patient, sometimes ribs do get fractured whilst performing compressions. You did the right thing though by doing compressions – it gave them the best chance of survival along with performing defibrillation. If you hear or feel ribs cracking / breaking, don’t stop compressions, but reassess the placement of your hands and continue. Or consider the depth you are doing, do you need to ease off a little? To make sure your compressions are working, you should be able to get a pulse with each compression you do – have someone try and locate a pulse whilst you maintain compressions. Simply, it is better for the victim of SCA to have a few broken ribs and survive, than not to survive because you were worried about breaking some ribs!
- Started breathing again: Excellent! Sounds like you did a great job. Yes, some patients will begin to breath again after being resuscitated. That’s what you are setting out to achieve when you first render SCA first aid. However, after getting a pulse back again, indicating that the heart is beating again, some patients will begin to breath, and some won’t. We can get the heart going again, but it may take some time for the breathing to begin automatically again. That’s OK. If you are trained and have an oxygen kit handy, you can then support the patients breathing by ‘ventilating’ them until help arrives. Alternately, you could do EAR (Expired Air Resuscitation) if you were happy to. If you have a pulse and the patient is now breathing again, and they remain unconscious, place them in the ‘lateral’ position and care for them until professional help arrives – usually paramedics. In the meantime, always make sure you monitor the patient until that help arrives – constantly take observations such as pulse rate, breathing rate, LOC (Level of Consciousness), colour (lips, face, neck and extremities), pupil size (should usually go smaller), and record such observations for paramedics when they arrive. You can keep your observations on our Clinical Notes handbook available at your Defibshop online store here.
- I could then feel a pulse: Fantastic! If you can feel a pulse return after doing resuscitation, that is great news. It is probable especially if you had access to a defibrillator and used it quickly, that your patient will get a pulse back. In fact, they may not only get a pulse back, but they may sit up and ask you what happened? As mentioned above with breathing, when your patient gets a pulse back, it is important to monitor all observations – pulse rate, breathing rate, LOC (Level of Consciousness), colour (lips, face, neck and extremities), pupil size (should usually go smaller), and record such observations for paramedics when they arrive. The patient may have a pulse, but not be breathing (the patient will never be breathing, and NOT have a pulse, but can have a pulse and NOT be breathing). You can keep your observations on our Clinical Notes handbook available at your Defibshop online store here. Remember that they may have a pulse, but still might not be breathing, so take a review of the notes in the above paragraph.
- What colour should they be? During SCA, the patient will most probably have turned ‘blue’ in colour. Take a look at the face, head, neck and lips. Each of these will usually have turned blue – or changed to ‘off colour’ for what would be normal for the patient. Ask those around what is normal for the patient. Record any details you can gather for the paramedics when they arrive. Should you successfully resuscitate the patient, colour may return to normal after a period of time, minutes to longer.
- What does it mean if blood coming from mouth?? It is normal for some cardiac arrest patients to have blood coming from their mouth during or after a cardiac arrest. There are several reasons this may happen. As the patient goes into cardiac arrest, they may have what is termed a ‘VF fit’, resulting from hypoxia (a lack of oxygen to the brain). The patient will fit for a short period whilst going into cardiac arrest, and when doing so, may bight on their tongue, resulting in blood coming from the mouth. Also, the patient may suffer trauma to the mouth during their cardiac arrest – whilst falling to the ground they may strike their head, mouth or jaw on something that results in trauma with bleeding. If there is blood coming from the mouth, commence and continue chest compressions, defibrillation, and if you have a mask or oxygen equipment handy, you might like to ventilate the patient.
*The above information is a guide only and is provided purely as general information to assist you. The information is a practical guide to what really happens when we see and render first aid to SCA patients. If you have any questions, or have a topic you’d like listed here with some information, drop us a message here and we’ll chat about what information we can come up with! Your Defibshop is keen to help you in any way we can.