A young man vanishes in the street and a group of 20 people gathers around him. They surround him in a circle, they watch him and remain immobile before the inevitability of death. They wait for an emergency team to arrive. Meanwhile, the clock has already begun to subtract seconds from life: for every minute of delay in the start of cardiopulmonary resuscitation (CPR), the chance of survival is reduced by between 7% and 10%, according to the guide The school teaches CPR, Prepared by the Spanish Cardiopulmonary Resuscitation Council and the Mapfre Foundation. The case of this young man in cardiac arrest, one of the 30,000 that occur each year in Spain, has been made public in his twitter account the doctor who treated him and who could not save his life. “The first eight minutes are vital to perform CPR, if it is done in that time it is possible to increase survival and reduce brain injuries,” warns David Garañena Bretaño, SUMMA 112 emergency health technician.
One strategy to increase the participation of citizens in this technique is its compulsory teaching in schools from 2020, so that all children learn to save lives and teach their families. Something in which the European Resuscitation Council places special emphasis: “All school-age children should routinely receive CPR training every year and be encouraged to teach their family and friends.” According to Garañena, who teaches CPR classes in schools, the technique is simple for minors because it has been simplified over the years and they can teach it to their relatives at home. “From the age of eight we show them what CPR is and its rhythm, and from the age of 12 they already have the capacity, due to their weight and physical structure, to be able to do it correctly,” she says.
The Royal Decree on organization and minimum teaching, which develops the new education law LOMLOE (2020), includes the cardiopulmonary resuscitation protocol among the basic knowledge of Physical Education in the third and fourth year of Compulsory Secondary Education (ESO). “The regulatory framework thus guarantees the presence of the practice of CPR in the basic education curriculum as a minimum compulsory course for all ESO students,” they point out from the Ministry of Education and Vocational Training.
“In Denmark, with teaching in schools, they have managed to increase survival from out-of-hospital cardiac arrest from 8% to 15% in 25 years,” says Esther Gorjón Peramato, an emergency nurse in an advanced nursing life support unit. (SVAE) in Castilla y León. Gorjón, who has 20 years of experience in teaching CPR in schools, also points out that to achieve results, future teachers must be trained in cardiopulmonary resuscitation at universities, provide all schools with mannequins to do the practicals , that children leave school with the basic knowledge of CPR and carry out publicity campaigns in the media on how to act in the event of a cardiac arrest.
Compress without word of mouth
The objective of teaching CPR in schools is not focused only on the child, but on the fact that he also teaches it to his family environment: “When I instruct children, I tell them that they also teach it at home, because most of cardiac arrests occur at home”, explains Eduardo Pérez, Physical Education professor at the CIFP Politécnico de Lugo, CPR trainer and coordinator of the CPR na Aula experience, on whose website you can see videos where children are trained and adolescents in this technique.
When explaining the technique to the child, SUMMA emergency health technician David Garañena recommends two linked steps:
- The first thing: check that the person is unconscious and call 112. “It is very important that you make the call before starting CPR. In the emergency service a doctor is going to give him the steps, the compressions he has to do, when he should stop… ”, explains Garañena. This SUMMA 112 toilet indicates the following to verify that the person has lost consciousness: “The child must pay attention to the fact that he does not respond to stimuli (when talking to him, when moving him), and when in doubt as to whether or not he is breathing, he should put the ear in his mouth to feel his breath and see if the thorax moves. If there are no signs of breathing, CPR should be started.
- Perform CPR. “The child must kneel on the side of the person, never on the lower part or on the head,” warns Garañena. The point on which he has to press is the center of the thorax: “We tell them that it is the area that is between the two nipples and we explain to them that if they press very low they will notice that it is very soft; Not there, the right area has to be hard”. The hands are placed one on top of the other interlacing the fingers and resting the heel of the palm on the center of the thorax so that when compressing all the force is exerted on that point. It compresses and relaxes without detaching the palm from the thorax or unlatching the hands. “You must perform the compression with your arms completely rigid, letting your weight fall on your chest and do the compressions without stopping. The important thing is that the child does them for as long as he can, if he gets exhausted he should stop, and as soon as he recovers, do them again ”, he adds.
Currently, ventilation or mouth-to-mouth is no longer recommended. “It is a highly complex technique that requires sealing your lips with the person’s lips and positioning the neck in a certain way. We have seen that all this stops CPR”, argues Garañena. And she adds: the children are going to do cardiopulmonary resuscitation to the best of their ability, and this is much more than if they do nothing.
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