This week we were lucky enough to be offered an hour of Basic Life Support training at the John Radcliffe Hospital. I firmly believe in taking every opportunity I can to refresh these critical life-saving skills, so it was wonderful to be fully-booked for the training: that's 21 more people with knowledge and skills to save a life if the worst should happen.

We learnt about the Chain of Survival, learnt and practised CPR for adults, discussed appropriate adaptions for children, tried using a defibrillator, were taught what to do if someone is choking, and practised getting people into the recovery position. It was a very informative hour which gave all of us the confidence to try to help if someone collapses in front of us.

Massive thank you to Aoife for training us!

Chain of Survival
Early recognition and call for help to prevent cardiac arrest - Early CPR to buy time - Early Defibrillation to restart the heart - Post-resuscitation care to restore quality of life.

CPR
Check it's safe to approach - Shake and call the patient to see if they are responsive - Tip head back to open the airway and check if they are breathing (listen and watch for chest movement) - Call for help (either get another bystander to call or dial 999 and put it on speaker phone) - begin CPR.
CPR - Interlace fingers, lock out elbows, press firmly in centre of chest with the heel of the hand. Press down to a depth of 1/3 the chest (in an adult this is about 5-6cm) allowing chest to come all the way up inbetween, keep going at a rate of 100-120 per minute until help arrives. Songs such as Nelly the Elephant or Stayin' Alive are about the right speed to help you keep about the right rhythm of the CPR. You can also administer rescue breathes if you are happy to do so at a rate of 2 breathes then 30 compressions, however if you are in doubt about your ability to do these properly it is far more important to keep the chest compressions going. If a 2nd first aider arrives they can get the nearest defibrillator and do rescue breathes.

In children the most common cause of the heart stopping is lack of oxygen, so it is best to administer 5 rescue breathes before starting CPR.

In all cases continue CPR until professional medical help arrives.

Choking
If someone is choking get them to cough if they are able. If that fails to dislodge the object/if they are unable to cough get them to bend forwards and slap them hard between the shoulder blades 5 times. If that also fails then try some abdominal thrusts. Do not put your fingers in their mouth and fish around as you may make them gag and vomit.

Defibrillator
Keep administering CPR while someone else prepares the defibrillator! When you turn a defibrillator on it will talk you through exactly what to do. It will not allow you to do the wrong thing. The sticky pads need to be stuck onto the skin so you may need to cut clothing to get them in place (there are usually scissors in the defibrillator bag). If the patient is wet or sweaty try to dry them off a little so that the pads stick better on their skin. Follow the machine's instructions. It will analyse the patient's heart and shock if appropriate. You need to briefly pause CPR while the machine analyses and shocks, but you should get straight back to CPR as soon as the shock has been administered. The machine will time 2 minutes then tell you to pause CPR, analyse and shock again, and continue that cycle. Keep going until professional help arrives.

Recovery position If someone is breathing but unconscious/unwell the recovery position is a safe position for them to be in until help arrives. The one exception is if you suspect a spinal injury, in which case do not move them. Follow these steps:
With the person lying on their back, kneel on the floor at their side.
Extend the arm nearest you at a right angle to their body with their palm facing up.
Take their other arm and fold it so the back of their hand rests on the cheek closest to you, and hold it in place.
Use your free hand to bend the person's knee farthest away from you to a right angle.
Carefully roll the person onto their side by pulling on the bent knee towards you.
Their bent arm should be supporting the head, and their extended arm will stop you rolling them too far.
Make sure their bent leg is at a right angle.
Open their airway by gently tilting their head back and lifting their chin, and check that nothing is blocking their airway.
Stay with the person and monitor their condition until help arrives.

Useful resources:
* CPR Spotify playlist here. * Lifesaver.org.uk. * Goodsamapp.org/medical. * resus.org.uk.

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