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A Different CPR

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Recently a woman who works in my office complex recently got an AED for home. Her husband who was a cardiac physician had recently gone into semi-retirement and wanted one for the home. I asked her if she had taken a CPR course and she told me that Walter had taught her how to do compressions and he wanted her to just keep pushing and not do any breaths. I know that his is a method that some groups are investigating and thought Walter just wanted to be sure the blood kept flowing.

About a week later, I ran into Linda and told her about an article I had read in the AHA Currents some time ago. The article suggested that you could sing “staying alive” from “Saturday Night Fever” as this has 100 beats per minute. I never figured out how to sing and keep count of 30 compressions at the same time, but since she was not giving breaths, she would not need to count and might be able to use the tip.

I wish I had had a video camera to record for U tube what came next. This small, older woman, began singing, “staying alive” while pumping her foot up and down on an imaginary manikin. I asked her what she was doing. She replied, “Oh, Walter taught me to use my foot because I don’t have the arm strength to keep up the CPR until 911 arrives. Walter is a big guy and it takes a lot to compress his chest.”

Walter, has come up with a procedure what will work best for the two of them, if Walter needs the AED. It may be something to think about for those who do not have the strength or stamina for CPR, or who have problems with knees etc. and can’t do conventional CPR. It was an image to behold.

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Fever

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As a BLS Faculty (Instructor-Trainer) in Ontario, Canada I must point out that if someone were to compress the chest of a casualty using the method suggested above the rescuer could find themselves in a lot of trouble. I realize that Good Samaritan Laws vary from state to state. In Ontario, our Good Samaritan Law states that someone who voluntarily assists is protected from liability unless it is deemed that they were grossly negligent. Given that we do not teach our students to perform CPR compressions using feet/legs, in Ontario at least, this might be considered grossly negligent. I have taught my students alternatives that still use the tried and true methods if they have arm/wrist problems.

II quite agree in a normal rescue, but this is a special circumstance. If you were a 6’4” 240 lb man who only has a 100 lb woman with weak arms and bad knees, and knows that the 911 EMT’s are at best 15 minutes away, what has the best chance of keeping your blood flowing. As to liability issues, the physician gave the instructions to the responder (wife) as to how he (the doctor) wanted to be treated when he was a victim. He knows his wife, and she just does not have 1500 compressions in her arms.

I have installed many defibrillator cabinets that must meet the American with Disabilities Act for access and wondered, just what disabilities would allow access and also allow application of the AED and CPR. There are many conceivable circumstances not meeting the norm, and yet have a very plausible alternative to achieve the same results. I see no reason why a foot could not provide appropriate compressions if done in an effective manor. There are even automatic compression machines on the market to relieve the EMT from doing compressions during transport.

While I thought the story was humorous, your comments have brought forth a serious concern. Being different may or may not be negligent. After all, in 2004 30 compressions before a breath could be construed as negligent, by a year later, failure to do 30 compressions would be negligent. As more defibrillators find their way into retirement communities and homes with an aging population, perhaps other methods for chest compressions should be considered and taught if applicable. If a single responder cannot physically do any more correct compressions, using a foot just might be a better alternative to save a spouse than just stopping CPR.

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