To be trained in the art of saving a life is a magnificent accomplishment. The feeling is amazing because it was you who leaped into action and started Cardiopulmonary Resuscitation (CPR). Sometimes when people need CPR because their heart has stopped does not always mean that helping them will be an easy task. Many people find themselves in situations where they are in a vehicle collision, and they are upside down, on their side, or even still sitting in the car. Of course, the obvious action to take is to remove them from that position and place them on the ground as you were taught in your course.
When performing CPR in an awkward position, the rescuer must be aware of primary and secondary hazards, such as smoke in the car, gasoline leak, angry dogs, or violent people. Once the rescuer determines that it is safe to do CPR, do it without hesitation. Even though the position is awkward, and the chest should be compressed to at least 2 inches, trying it is better than doing nothing at all. So, how would a person go about performing such a difficult task?
A strong man or woman can probably perform CPR in an awkward position with relative ease. However, anybody else will find it hard to do. In the sitting position, place the heel of your hand on the center of the chest. After, push as hard and fast as you can. Although the back of the chair is soft, and you need to place the victim on a hard flat surface, do your best to accomplish this task. Be aware that you are in the victims’ faces, and he or she may vomit, so take the appropriate precautions by being prepared.
If a victim is upside down for any reason, and you are unable to reverse them to a prone position, pushing on their back has not been proven to be an effective technique to permit perfusion. If you can get underneath them (plenty of space to do so), use both hands and push as hard as you can. In one situation in my past, I had a victim who suffered cardiac arrest before he crashed his vehicle into a wall. The damage and trauma to his body were minimal, but he remained in the vehicle. I was unable to pull him out in a good time where he would have no permanent brain injury, so I positioned myself behind him and reached around his chest and squeezed rhythmically, just like normal chest compressions. It appeared that he was getting the Heimlich maneuver on his chest, and it was making a difference.
This victim in cardiac arrest in the vehicle ended up in a prone position until his airway was manually controlled. “Most of these visitors extricated after the initial disentanglement attempt. I continued to do the modified Heimlich chest compression technique until he had a Return of Spontaneous Circulation (ROSC). This technique was accomplished without Advance Life Support (ALS). With a typical call, most Emergency Medical Service (EMS) providers would have pronounced the victim on scene. However, with a bit of creative ingenuity and determination, a brief period of a positive outcome was the result.
In other situations, a victim may be found in a tight situation and lying on his or her side. You realize that it will take just a few minutes to remove them, so you position yourself to where you can do lateral chest compressions. This technique is also a very difficult task, but your efforts will indeed be recognized, and you may find that you made a difference. Once you get the victim in a supine position on a hard surface, proceed with your training by pushing hard and fast on the chest.
In this world, anything is possible. You may find yourself in a position to help someone, and it may be the most awkward time of your life. However, you must be aware that to do something is a positive thing. However, to do nothing because the victim is unreachable (in your opinion) does not place you in negative litigation. You may also blame yourself because you felt helpless. To blame yourself is a normal response from a person with a good conscious. But, understand that you called 911 and got professionals on the way. Those feeling are also awkward but will subside over time. If you feel that you have felled (but in reality, have not), give comfort to family and friends. That in itself gives a subconscious feeling of satisfaction that will trickle to the surface. Either way, you are a HERO!