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Wednesday, May 23, 2018

Staying Alive - The Hands Of Life

Courtesy of WOWSA, Huntington Beach, California.

"It may never happen to you, but it is always good to know how to give CPR [cardiopulmonary resuscitation] to people in an emergency," advised Steven Munatones.* "You might see someone in need while walking on the beach, while swimming in a race, at the pool, in a public area, during a channel crossing, or at home. You just never know when this skill might come in handy."

The state of California started to mandate teaching on hands-only CPR to all high school seniors in public schools.

"Educating a new generation of lifesavers (i.e., high school students) in the United States is extremely important for three primary reasons," said Munatones.

1. Younger people are more likely than older people to aid someone in need in emergency situations. Many people panic, do nothing or are afraid of hurting the person in need or want to avoid any potential or perceived liability problems.

2. A public health study in Kyoto, Japan found that hands-only CPR (otherwise known as compression-only CPR) led to higher survival rates with more favorable neurological outcomes compared to compressions with mouth-to-mouth artificial resuscitation that earlier generations of lifesavers were taught. Hands-only CPR is also easier for anyone to learn and execute in an emergency.

3. The large, aging Baby Boomer population will experience more heart attacks in homes and public areas than any other time in American history.

That is, hands-only CPR can not only keep people alive, but also result in losing no neurological functions due to heart attack and a lack of blood to the brain. Quick action can help keep people alive and enable them to thrive in the episode’s aftermath
."

Hands-only CPR is CPR without rescue breaths. The American Heart Association recommends that if a teenager or adult collapses, bystanders can perform Hands-only CPR with two easy steps:

1. Call 911 [or the emergency telephone number in the immediate area], and
2. Push hard and fast in the center of the chest - 100 beats per minute. The chest compressions can follow the beat of the Bee Gees’ disco song Stayin’ Alive which is 100 beats per minute – the minimum rate to push on the chest during Hands-only CPR.

With 70% of all out-of-hospital cardiac arrests happening in homes, family members or fans are more likely to save the life of someone they know and love. Hands-only CPR carried out by a bystander has been shown to be as effective as CPR with breaths in the first few minutes during an out-of-hospital sudden cardiac arrest for an adult victim.

70% of Americans feel helpless to act during a cardiac emergency because they don’t know how to administer CPR or they’re afraid of hurting the victim. But the American Heart Association launched a campaign in 2012 to raise awareness of Hands-only CPR as a critical lifesaving method and to increase the likelihood of people to perform CPR in an emergency.

* Munatones will give the following speech as a heart attack survivor at the American Heart Association Emergency Cardiac Care Education Conference (see here):

The Hands of Life

This morning, like every day over the last two years, I woke up and smiled. It was another bonus day, another beautiful morning. It was another day in which I cheated death. Frankly, I should not be alive and I should not be here.

I was extremely busy in May 2016. I traveled back and forth from LAX to Tokyo, then went immediately to New York upon my arrival home, and then was called back to Tokyo. Two transpacific flights separated by a cross-continental flight - all in 11 days. When I returned home from LAX, I remember going down to San Diego with my family. It was a Sunday night and the last thing I remember was a Korean restaurant where we went to eat dinner.

The next thing I knew, I woke up and had to go to the bathroom. But I remember my mother and wife standing by my bed. That was really strange, I thought.

But I really had to go to the bathroom and started to get off the bed.

My immediate thought was, “Why is my body so heavy?”

Then I realized that I was in a hospital. I hate hospitals. Visiting a hospital can only mean that one of my kids or a family member or friend must have had an accident or fallen terribly ill. Or maybe it was my father? He is 82. I was worried to find out who was in the hospital and why.

But as I tried to sit up, my mother blocked my way. “You can’t get up,” she said. She literally put her body against the bed and wouldn’t let me get up. C’mon Mom, I thought. I have to go pee.

Tears were streaming down her face and she repeated, “You can get up. Wait until the nurse comes. You had a heart attack.”

What?!?

Heart attack. Those words just didn’t register. It didn’t make sense.

But my immediate thought at that moment was going to the bathroom. I was about to urinate on myself. The last thing that I wanted to do is pee on myself with my mother and wife in the room. But my mother was blocking my way, not letting me off the bed. At that moment, I noticed I had tubes all over me: in my forearms, up my nose. That was my second shock. Things was coming in and out of me all over the place.

What was going on?

The nurse came in and I said - sort of rudely I must admit - “I have to go to the bathroom.”

My mother moved aside and the nurse kindly helped me get up - very slowly - and I shuffled - very slowly - to the bathroom. Everything was so heavy and everything was moving in slow-motion. I clearly heard what my mother had said to me, but I could address that situation after I urinated.

As I stood by the bathroom with the nurse firmly holding me, she whispered, “You really should listen to your mother. You did have a heart attack.”

With her steady hands on my shoulders, her words literally stung. I was hurt and shocked. I heard my mother and the nurse. But none of this made any sense at all.

So a physician - clearly someone with authority and compassion - darts in the room and starts to ask me questions, slowly. How are you? How do you feel?

I answer his questions, and he explains what went on, but I don’t clearly remember what he said. My mind was just processing what I was told - and then I had a bunch of questions myself.

First and foremost, whatever did actually happen to me, I had to get out of this hospital. Soon, like tomorrow. I had to get these tubes out of me and off of me. And I needed to put pants on. I hate wearing hospital gowns.

My need for speed was simple. I knew my son’s water polo tournament was on the weekend and I needed to get out of here so I could watch him play.

As Dr. Carter, my cardiologist, finished his explanation, I asked him an all-important question. This was the thought that was consuming me.

“When can I get out of here?” I don’t remember exactly his answer, but I sensed his answer was something that I did not like. So I applied to him again. “I feel fine, doctor, but I have to get out of here because I need to see my son’s water polo tournament this weekend.”

Dr. Carter looked around puzzled. He looked at my wife and asked when the water polo tournament was. She said with the saddest look I had ever seen, “Last week.”

Now I was thoroughly confused. I should really listen to my mother. And then my wife proceeded to explain what happened, holding my hand.

“You didn’t get up early last week and swim in the early morning like you always do. You told me that you were tired. Over our 24 years of marriage, you had never told me that you were tired. You never skipped your morning swim. So I thought it was best that you sleep in and get some rest because you had been traveling so much.

I went downstairs to make the kids’ breakfast. Then I heard this strange gurgling sound from your bathroom and then a loud sound. A thud. I ran into your bathroom and you had fallen. You were out. You weren’t moving at all and I knew you were in trouble. I never want to see you like that again. It was terrible.

Then Skyler came down the stairs when he heard me screaming. I didn’t know what to do. I was so scared.”

Tears were streaming down her face.

Skyler is our 17-year-old son. Fortunately, he did not have his normal early morning water polo practice that day. He was home - as were our twins who were also crying and screaming when they heard my wife’s screams. No one knew what to do. It was the ultimate scare.

My wife called 911 and then Skyler started to give me hands-only CPR. Skyler is not a lifeguard. He has never taken CPR or any first aid classes in his life. But the 911 operator helped talk him through giving me regular chest compressions.

Skyler is not a big boy, but he plays a tough sport with most boys must much bigger and stronger than him. But he always comes through in important games and he always takes the pressure-packed penalty shots for his team. My own Mr. Clutch was living up to his reputation on that day.

Skyler continued to give me hands-only CPR without any preparation or education. His only desire was to keep me alive.

I did not look alive. I was not breathing. My eyes were closed. My body - by this time - was limp - crumbled - flat on the bathroom floor.

My hero Skyler kept on giving me deep chest compressions. Skyler certainly had the strength and stamina after playing water polo for over a decade.

But most importantly, he was focused. He did not panic and he did not stop. Whatever instructions the 911 operator was giving him, he followed to the T.

Skyler keep my blood flowing. My life literally was in his hands. Life is in the blood as the Bible says and Skyler kept my body alive and my blood flowing. Up and down, up and down. He never let up. I am here because of his focus and belief that he was doing something right. He could not just stand by and watch life being sucked out of his father.

When the paramedics came, they said Skyler was doing everything right. They quickly put me in the ambulance and rushed me to Hoag Hospital in Newport Beach.

I learned later that three other men in their 50's had experienced heart attacks on that same morning within an hour of my ER visit. They were taken to the same hospital. None of them, unfortunately, made it.

But I had Skyler at my side. He was a 17-year-old high school student who did his very first CPR on me - his father - when I was extremely vulnerable. He did CPR with his mother crying at his side and his younger sisters screaming in fear.

My life was literally in his hands at that moment. Perhaps it took 4, 5, 6, 7 minutes or maybe longer for the paramedics to arrive. But he came through when it counted the most. It was remarkable because his hands had never before been clasped together and pumped blood through a heart.

In the emergency room, Dr. Carter put a stent in my left ventricle. The doctor asked my sister who was a nurse at Hoag Hospital and my wife if they would approve the Arctic Sun protocol. The doctor warned my wife that I probably might not be the same if I came out of it and I might have severe neurological damage as a result, but my wife never lost hope.

During the days when my core body temperature was dropped, I was not conscious, but apparently, they had to tie my arms down because I was moving so much as my body temperature was being lowered.

My wife later told me, “I knew you would make it. You could not die after everything that Skyler did for you. I HAD to live."

My wife - as usual - was right. I did not die. I am only here because a 17-year-old high school student - without zero CPR education or experience - was extremely calm under pressure and did hands-only CPR. Flawlessly.

If he can do, anyone can.

In contrast to groundbreaking science, the abundance of pharmaceuticals, and the vast amount of technology and tools available to physicians and nurses nowadays, we can all help keep people alive - with our bare hands.


Photo shows Canadian Karley Stutzel who was pulled from the 2008 Olympic 10K Marathon Swim qualification race in Beijing, China, but quickly recovered and was later released from a local hospital.

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