The 2015 Guidelines allude to this section when they discuss what an untrained responder would do. They mention putting the phone down and dialing 911 and then starting compressions. I have applied it to the explanation below.
CALL 911 AND GET AN AED!
This common phrase is repeated over and over during the adult portion of every CPR course. What is not repeated or explained coherently is what happens when you is You. Suppose no one else is available to assist you and no one responds to your calls for help. What do YOU do? Do you leave the victim and go looking for a phone and an AED? Do you run down the path or out the door and call for help? Do you ask the first person you can find if they know where an AED is and could they call 911 for you? All of these actions could be an alternative if you are alone when you find someone who has collapsed and is not breathing.
The answer is simple. If you know where the AED is and can gain access to it within 4 minutes round-trip then go get it. The victim’s brain will begin to die if it doesn’t have oxygen within 4 minutes of collapse. In approximately 10 minutes if the brain is deprived of oxygen it will be almost dead. The only exception is if the victim drowned in cold water or has taken certain drugs including opioids. Under those circumstances the brain will live a while longer. The average victim does not have that much time.
To further complicate matters if you go looking for help or to get the AED, but don’t know exactly where it is then you will waste valuable time looking for it. Human beings think in portals. What do I mean by portals? Picture yourself in the living room and you remember you left something up in the bed room and race up the stairs to get it. Then once you cross the doorway, you say to yourself “now why did I come up here for” you forgot why you came up. It happens to all of us. So, if you decide to go looking for the AED and you start pulling out drawers and opening cabinets, there is something very important you forgot. You got it! It is the victim who is not breathing. By the time you get back to them they will probably be dead.
So what can you do? You can use your common sense and realize that you are not superman or woman. However, you probably do have a cell phone. If you put the cell phone on speaker and dial 911 (see figure 1) immediately upon realizing that you are alone, YOU will be talking to a 911 dispatcher within 15 seconds.
Once you get connected you tell the dispatcher you are alone and are performing CPR. The dispatcher will immediately push the call button and signal the Emergency Medical Service personnel to respond to your location. While you are doing compressions you can tell the dispatcher where you are. Now you have people with life- saving equipment on their way to help you. Not only didn’t you neglect the victim, you actually acted in a responsible fashion and gave the victim the greatest chance for survival.
As a side note it is important for the victim and for you to keep your phone’s location on E-911. If something happens to you and your phone is on the rescuers can locate you too.
Before you ask, if you are alone and don’t have any barrier or mask, don’t deliver breaths unless the victim is a close friend or family member. Deliver compressions by putting the heel of one hand in the center of the victim’s chest and then bring the shoulder of that hand directly over your wrist (see figure 2).
Then intertwine the fingers of the other hand or put the other hand around your wrist for support. Press down at least 2 inches. You will be surprised how easy it is to press in the center of the chest by keeping your shoulder over your wrist and the heel of the hand in the center (see figure 3).
If you are going to deliver breaths to a close friend or family member after 30 compressions, remember to grasp the victim’s nose with your forefinger and thumb of the hand you are using to tilt the head back with. With the other hand, pull the victim’s jaw up towards you. An easy way to do that is grasp the jaw under the lip with your thumb and forefinger and pull the jaw up and then place your mouth over the victim’s mouth. With your mouth positioned this way, give 2 slow breaths. After delivering 2 breaths immediately go back to delivering compressions.
Remember when you deliver effective compressions you are pumping oxygenated blood to the brain. Also, with good compressions you are also causing the victim to draw air in through their nose and lungs to keep the blood oxygenated. Effective compressions delivered continuously provide the best chance of survival. The first two minutes of CPR are the most critical and set the stage for what follows. The less time we spend “looking for an AED” or trying to get breaths in, and the quicker we start compressions, the better the chance is that the victim will survive. Saving Time Saves Lives. We are not born as heroes. We train to become heroes for others.