I need to refresh my CPR and first aid training...

I watched a friend almost die today. It was possibly the scariest thing I've ever experienced.

A group of us were mtn biking in central PA. Planning to do a 19 mile ride through some classic rocky PA single track.  We meet at the parking lot at around 9AM and finally get moving around 9:45.  The first section of the trail is about a mile long and ends at a gravel road.  We stopped to regroup and just as we were getting ready to start moving again, one of us is walking his bike up towards the front, goes rigid and collapses to the ground.  At first we thought he has just messed up getting clipped into his pedals (happens to all of us...). We quickly realized this was no joke.

He was having a heart attack.

Cell coverage in the hills of central PA is notoriously sketchy. But fortunately, by luck a few of us could get through to 911 while a the rest of us tried to figure out what was going on and what to do.  At first, it looked like he was having a seizure, but when his lips started turning blue and we had trouble finding a pulse, one of the guys with reasonably recent training started compressions. This seemed to work and we soon realized we had to keep the compressions going until the EMTs arrived as when it seemed like he was pulling out of it and we stopped, he started going blue again. 

After a few minutes that felt like forever, the first EMT arrived - the fire chief.  Who basically told us to keep doing what we were doing until additional help arrived, which was a few minutes later. Another EMT in a emergency truck and a volunteer on his motorcycle. They took over and had a defibrillator which started to get him stabilized. Then more arrived - fire truck and an ambulance. With additional, more trained people there, they eventually got him stable enough to load into the ambulance.  While this was happening, we saw a medivac chopper from Hershey fly overhead to meet the ambulance at a landing area near by.  

One of us called his wife after the EMTs asked about any medications. He is apparently on blood pressure meds and none of us knew what it was.  The ambulance crew got him stable enough to load into the chopper and a few minutes later we saw it fly again over us towards the hospital.  After a bit of clean up and some help from a State Trooper to get his bike back to our cars, it was all over.

A few minutes later while we were collecting ourselves back at the cars, the fire chief pulled up next to him. He told us we was awake and alert before the loaded him into the chopper and our efforts until help arrived saved his life.  He said basically what happened was the electrical signal to his heart got disrupted somehow and that is what caused the cardiac arrest. 

We were incredibly fortunate the heart attack happened where it did.  There are sections of the trails where getting him out would have been very difficult. As it was were about a mile from the main road and maybe 5 miles or so from the town that sent the response team. It could have been so, so much worse.

So, this was a long and frightening story that basically says my CPR training is woefully out of date.  My training was back in the time when you did mouth-to-mouth.  Apparently, you don't do that now - just continuous compressions.  But whatever the correct procedure is, I need a refresher course.  

He's lucky you guys knew enough to keep him alive until the paramedics got there. You can buy defibrillators for home emergency use now that would be handy to have in the trunk. When it is activated it gives instructions- pretty neat.

What you did was as good if not better than what they teach non-medical, non-first responders these days.  The current classes for plain ole lay-people is just dripping with litigation.  

Step 1: call 911 or generally seek the help of professionals. (You are not qualified so seek someone who is.) 

Step 2: start compressions. (The reason you seek a pro first is now that you start compressions you are legally bound to continue doing them. It's not like you can stop now to call someone.)

The mouth to mouth portion was dropped because of the risk of person #1 giving "the funk" to person #2. 

You did great! 

Just out of personal curiosity, did E-911 work?  That is, were the operators of 911 able to pinpoint your location within 30 ft of where you were calling from? 

The reason I ask is that since like 2006 it has been illegal to sell a cell phone in the US that is not capable of this technology, yet there has been no mandate that municipal 911s have to be equipped with the capability.  It's a huge problem. 

The best thing you can do is to be able to clearly articulate your location because without that, they may never find you. 

Sample story

I don't think I've had CPR training since middle school. And I had no idea that you aren't supposed to do mouth-to-mouth anymore.

In reply to Tom_Spangler (Forum Supporter) :

You can do mouth 2 mouth. It is actually very good and helpful.  What has changed is that they are not telling you that you have to (for litigation reasons.)   They have dumbed down the instruction. 

Next time you see a life guard, on their fanny pack they will have a plastic gadget. It is an adapter so that mouth #1 doesn't actually touch mouth #2. 

Sample gadget on Amazon $10

Yeah, it's all changed. I think AIDS and TB and who knows what else did away with the mouth to mouth part of it. I wonder if it was ever an important part of it? Like what percent chance of the responder catching something vs any incrrase risk of death of the victim. 
 

Great job. You guys did good. 

Disease is one reason we tell people not to do breaths anymore, but the real reason is actually because it stops you from compressing. With each compression you build diastolic blood pressure from the heart "sucking" venous blood back to it, and more of that suck has been linked to much better outcomes because it makes you perfuse better (i.e. bloods going to more places). The blood has ~5 minutes of oxygen in it for the brain at normal times, going in a coma means you have so much available it's better just to keep pushing.

The first step of CPR is to take your own pulse. Since he was waking up later, it's obvious you acted instead of reacted. Good job Ian. You literally saved his life.

In reply to GIRTHQUAKE :

Thanks for the info. When I fist learned there was 1 person and 2 person versions. The current method is easier to remember. Glad to know it works as well.

In reply to GIRTHQUAKE :

Someone mentioned that - the compressions are more important, so don't stop doing them.

I honestly didn't really do much. One of the other guys did the compressions. I held one of his hands and tried to keep his head steady.

Keychain

Here is a keychain with a mask and a one-way valve so the down person can't cough into you if you have need of doing a breath. As stated, compressions are most important, but if you need to an there you go.

$2 each and tiny, so easy to drop into a kit.

One thing to think about in case there is a next time is that EPIRB/PLBs have gotten pretty cheap -- a few hundred bucks for a pocket device that'll summon medical help to your location without needing a cell signal.

Great job acting quickly.

Perhaps your job can schedule a day to get everyone First Aid trained? Several years ago I was a rent-a-cop and had to do so, it was about 3 or 4 hours. I remember doing CPR to the rhythm of the Bee Gees' "Stayin Alive". 4 compressions (ha-ha-ha-ha), pause (stayin alive-stayin alive), and repeat. The compressions were a lot harder than in the movies, like you could damage the sternum.    For mouth-to-mouth we just had a breathable plastic sheet folded in our kit, those valves look way better.

Well done, my friend.

Awesome job!

Any updates on how he's doing this morning?

In reply to XLR99 (Forum Supporter) :

Yes - just got an update.  He talked to one of our friends yesterday from the hospital.  In some pain and trouble breathing/talking from 5 cracked ribs, but I understand that's normal from the compressions.  EMTs told him he was dead for 12 minutes. More tests scheduled for today and tomorrow to better understand what happened. The initial chest x-rays from yesterday gave some symptoms of Covid, but fortunately the test came back negative.

And as far as the E-911, I don't really know.  Fortunately, we were on a named road, despite it being gravel and the first responders more or less knew where we were. Plus, one of our group rode out to the main road to tell them where we were. 

matthewmcl (Forum Supporter) said:

Keychain

Here is a keychain with a mask and a one-way valve so the down person can't cough into you if you have need of doing a breath. As stated, compressions are most important, but if you need to an there you go.

$2 each and tiny, so easy to drop into a kit.

I'm sorry you had that - you did well.  The keychain breather is good.  My wife and I were lifeguards for many years and thus had our number of uses for cpr/rescue breathing/first aid.  It is really reasonable to get training on it via your local ems.  Most states save you from litigation risks with good samaritan laws but it's worth an ask when you get your training.  It is really lucky that you guys got ems service so fast on a mtb trail.  Hope everyone if the group shares your interest in gaining a bit of rescue knowledge after this.

That's awesome!!  Well, not the down for 12 minutes part.

I've done CPR quite a bit over the last 30 years, only once have I been able to hold a conversation with the person afterwards. 

You and your friends did amazing work.

John Welsh (Moderate Supporter) said:

In reply to Tom_Spangler (Forum Supporter) :

You can do mouth 2 mouth. It is actually very good and helpful...

To clarify...

You don't do mouth to mouth if it means that you are unable to continue compressions.  Which generally means that you can't do it unless there are 2 or more responders.

For those of you who haven't had CPR since grammar school...

Training certification generally only lasts 2 years (1 year if you are in a medical field). 
 

That may mean that you were NOT certified for 10 or 15 cycles. (And the recommendations change regularly)

Go get certified. 

Also...

AIDs, etc is not the primary reason that mouth to mouth is not the priority any more. The main reason is to save lives. 
 

Air does no good if your heart is not pumping. Keeping a heart pumping at least circulates something. 

In reply to Ian F (Forum Supporter) :

I failed to say it, but great job!  I know that was scary, but you did exactly what you should have. Even if you felt like you were stumbling through it. 
 

Keep him alive until the pros get there.

Awesome!  Thanks for sharing!!

5 cracked ribs... that means you did it right. 
 

Generally speaking, if you are compressing enough to pump the heart, you are gonna break a rib or the sternum. 

Wow. Very nicely done; if you haven't already, look up CPR survival rates and then pat yourself on the back again. That's awesome!!

In reply to Ian F (Forum Supporter) :

You helped save a life. That is stellar.

XLR99 (Forum Supporter) said:

That's awesome!!  Well, not the down for 12 minutes part.

I've done CPR quite a bit over the last 30 years, only once have I been able to hold a conversation with the person afterwards. 

You and your friends did amazing work.

 

This - the odds of coming back after CPR are really low...  Be proud and ensure your buddy understands.