Kent's CPR Lessons

This is about my journey learning to perform and teach CPR.  Looking back to my teenage years (about 1963) in Las Cruces, New Mexico we didn’t know much about the heart and less about heart attacks. The concern we had primarily was drowning.  This city is near the banks of the Rio Grande River, and we had irrigation canals and a community swimming pool and some (a few) of our peers and families had private pools.  So, in the Boy Scouts we learned one of the early precursors of CPR.  “Back pressure, arm lift” was what we planned to use if we discovered a drowning victim.  How was that supposed to work?  First, we were to pull the victim from the water, lay them on their stomach, cross their arms under their head with the head turned to one side, and then kneel at the head end and press down on the shoulder blades and alternatively pull up on their elbows saying “Out with the bad air, in with the good air”. As one of the Patrol Leaders I helped my troop practice this from time to time.  I have no knowledge if it ever was used or if it worked. 

Today CPR or Cardiopulmonary Resuscitation is a wonderful technique to keep the heart and brain suffused with oxygen when the heart stops.  Why would the heart stop, after all, it’s been pumping blood for all of your life (over 2 billion beats for me, so far).  Lots of things can help to stop the beat – electric shock, trauma, loss of blood volume, drowning (asphyxiation) and of course atherosclerosis and arteriosclerosis.  (There are way too many to cover here!) Those last two are often associated with your diet, lack of exercise, even genetics and lead to blockage of cardiac vessels. And they stop the heart by building up a blockage in the coronary arteries (a fatty plaque). They also cause build up of plaque in other arteries which leads to other problems (stroke for one).  Different combinations of things can conspire to bring about blockage of the arteries of the heart or compromise of the nerve bundles and then death of the heart muscle and its nervous system.  So, when the heartbeat falters or stops there is now a chance to support life if those around the victim know CPR and even a better chance if there is an AED (Automated External Defibrillator) handy.  Calling 911 will get advanced care. If you don’t call they will not come!

There are many ways to learn CPR and many places with AEDs.  Check all that out at the American Heart Association web site (www.heart.org ) 

Here is an excellent history from Wikipedia   https://en.wikipedia.org/wiki/History_of_cardiopulmonary_resuscitation. 

After I joined the Navy and became a Hospital Corpsman I was introduced to a more advanced form of resuscitation and to Mouth-to-Mouth ventilation.  I never used that at any of my duty stations but for a while in 1972 I was the night orderly for a civilian hospital in Oakland, California and was involved several times in “Code Blue” attempts with some degree of success.  These involved not only performing mouth to mouth and/or air bag ventilation but external cardiac massage.  The first to recognize cardiac arrest was to strike the midline of the chest (on the sternum) with a closed fist (termed a precordial thump) call loudly for help and provide ventilation and heart massage.  As the male on duty, I got to be the “pumper”, kneeling on the bed with the victim on a back board as I pumped up and down on the chest while the nurses ventilated and performed other duties until the doctor declared the patient deceased or the patient began to breath on his/her own.  On one such occasion the patient was bleeding out and the nurses were administering blood intravenously.  To force the blood in faster they had wrapped a blood pressure cuff around the bag.  As they applied pressure the bag burst showering those of us at bedside with a full unit of packed cells. That was a mess!   As I recall, forty years later, we had success with less than ten percent of positive outcomes.  I was introduced to External Defibrillators at that hospital (one brand was the “Life Pac”) those were not portable and required special training.  They were also dangerous because if you were touching the patient when the system was activated you would get shocked too. That is still true with current AEDs.

Jumping ahead to 1992 I retired from the Navy and moved to Lakeland, Florida and took a job teaching for a private college who asked me to teach a course of First Responder First Aid.   My students were interested in being “certified” in CPR, however the school was not willing to underwrite that certification but said if I wanted to provide it that was fine with them.    So, I first became certified as a CPR provider then took the CPR Instructor’s course.  Then, working with Citizen CPR Inc. of Lakeland (https://citizencprinc.org ) I began offering CPR classes to my college students.  One day while teaching there a student blew so hard into the manikin, he burst the lung bag like a balloon.  Those students got to see me perform thoracic surgery to replace the lung.  Citizen CPR was then and is now one of the primary providers of public CPR and First Aid training in Polk County and I served as one of their community instructors and as Training Center Faculty from 1993 through 2018.  I taught (lead really) so many Instructor Training/Recertification classes that one of my fellow instructors dubbed me the “Training God”, gee thanks Arlene.  Teaching in the community involved dragging our manikins, 1 per 8 students, (ResiAnnies at 40 to 60 pounds each) and other equipment into their homes or businesses and lecturing, then demonstrating, then watching as the students practiced and tested. When judging student competence, I was always wondering if I someday needed CPR which student I wanted working on me.

Today’s manikins are far lighter, but many varieties do not truly resemble humans and some instructors do not like to use those.  After a year or so at the private college I moved on to what is now Traviss Technical College in Lakeland and taught the Medical Administrative Assistant course until it was daggered/closed by the Florida DOE (26 years).  While there I established a CPR Training Center so we could directly provide CPR training and cards for the Healthcare students, the Electricity and Air Conditioning students, and other interested students or staff as well as providing Instructor Certification for the school staff.  We didn’t provide public classes as that was already well covered by Citizens CPR. Soon after this the Amrican Heart Association (AHA) established video-based instruction that standardized the presentation with “Watch then Practice” courses. This was met with disdain by a few instructors leading to their decision to retire.  Now every course needed a VHS/CD player and TV or screen.   The Traviss Training Center expanded over the years to include Training Sites at Ridge Technical College and several middle and high school programs throughout the county.  As the senior Instructor I got to visit many of those schools, or the instructors came to Traviss.  I think this outreach has been hugely beneficial.

CPR has changed markedly during my era of involvement (new manikins, video and on-line classes, AEDs, Hands Only CPR, teams- either preadmission or in house, and 911 Operator Assistance, etc.).  I was among the first to be certified to teach AED use.  Hands Only CPR is a new initiative and you can take the class on-line for free (Hands-Only CPR Resources | American Heart Association CPR & First Aid).

Teaching CPR has been a wonderful experience as new provisions and equipment have been introduced creating greater chances for survival when the need arises. 

Please take the time to learn CPR and how to use an AED.

                                                     Kent