Understood.

As to your first scenario, you could check with a doctor about this, but I don't think that you have will any indication that you are about to quit breathing. You will probably lose conciousness first, and will probably not have any advance notice of that, either. Even if you do have warning, you will probably have other things on your mind besides giving your instructions to an onlooker.

As to the second scenario, your desire to help others is to be applauded, but you might be asking for trouble approaching it as you have described. Having the untrained perform any procedure on other people could open you up to all kinds of legal problems. I believe that most Good Samaritan laws will permit good faith assistance rendered by someone when the other person's life is in danger, but that assistance cannot exceed the rescuer's training and experience. Let's assume that you find yourself in the second scenario, and you give someone your CPR instructions and send them off to help the injured. If that person does not have proper training, and they wind up hurting, crippling or killing someone, they will be legally liable, and you may be too, since you gave them the instructions in the first place. You should NEVER accept or enlist CPR assistance from anyone that is not medically trained or Red Cross certified.

As I indicated in a previous post, you would be MUCH better off becoming a Red Cross CPR instructor and teaching CPR to as many people as possible before either scenario occurs. That way, there is a greater likelihood that the people around you can render appropriate aid, rather than having to find and rely on printed instructions when time is critical.

There may be better places to put directions to your personal CPR instructions than on a bracelet, but I think that you'll find that people are going to be more likely to look for medical info on something that resembles a Med-Alert bracelet or necklace than would look in a CPR pouch (assuming that it's still hanging out of your pocket, and they know what it is in the first place). If you are that hurt, will the little keychain have survived the incident? If the potential rescuer has to turn you over to find your pouch, and your spinal cord is severed in the process, what good has your pouch done? If you want your instructions to be found, you should put them, or the directions on how to find them, in the place where the potential rescuer would be the most likely to look, wherever that may be. Otherwise, you may assume room temperature or sustain brain damage long before the instructions are ever found.

If your second scenario occurs, there will be a lot more people in need of first aid than in need of CPR. You should be certified and prepared to render either one as needed. If you are going to accept or recruit the aid of the untrained, they should be used for such things as going for help, meeting the ambulance and directing them to the scene, directing traffic, ensuring that the area is safe, comforting/calming the injured, etc.

>>Here's one scenario. I have been injured but am conscious. I give the instructions to the only person in the situation with me right before I quit breathing.

I have to agree with TackDriver. The chance of you having advance knowledge that your heart is about to stop beating is almost nil. The time the other person wastes trying to read and understand the card would be much better spent calling 911.

If they position their hands incorrectly, they will break off the Xiphoid Process, which is a small piece of cartilage at the base of the ribcage (where the two sets of ribs meet). This can cause serious, potentially fatal internal damage. Couple this with the fact that you may not, in fact, be in any danger and you’ve just turned a simple fainting spell into a lacerated liver, internal bleeding, long-term complications, and possibly death.

Most of my students have difficulty positioning their hands correctly – this includes people who were previously CPR trained, after they’ve watched an instructional video and I have demonstrated the proper technique in person.
I’d think twice.

>>2nd Scenario. There's a huge wreck and hundreds of bodies which need attention. While i'm giving CPR to victims I can give the instructions to a good samaritan and allow them to help others as well.

Proper response to such an incident, if there are not enough first aiders to treat all the injured, is to assume anyone without a pulse is dead and move on. Harsh, but while you’re dicking around trying to teach Joe Hysterical Bystander some complicated life-saving skills, 6 people that you could have saved have gone into shock and died. I suggest you re-read your First Aid manual on MCIs.

>>Although I have been CPR trained for over a decade, have retrained, and performed this task to save a life I think a good set of instructions could help a good samaritan who has never done it before. The instructions I am making show very detailed pictures and instructions.

Well, I’ll take your word for it that you are CPR trained, but if I were your instructor, I suspect you would not have passed. You don’t seem to understand the difficulty or the danger of what you are suggesting.

There’s a reason CPR is the longest module in the book, and a reason why Saint John, Red Cross, and all the other organisations that teach First Aid recommend annual retraining in CPR, even for paramedics and nurses.

Sorry if I sound harsh, but CPR is just not something you can learn from scratch off the back of a cigarette pack.

This is, of course, just my crabby opinion <img src="images/graemlins/mad.gif" alt="" /> and does not reflect the attitude of Saint John Ambulance or any other organisation I work or volunteer for.

After reading the posts on CPR, I thought I would throw my 2 cents in for what it is worth. To be effective CPR must be started within 2-3 minutes of a cardiac arrest, preferable within the first minute. Without CPR and depending upon the age, medical condition (previous history), environmental factors (temperature) and several other factors, between 3-5 minutes post cardiac arrest, irreversible brain damage will occur, much after 5-8 minutes you are an organ donor. The exception for this is a cold water drowning, where individuals have been successfully revived with minimal or no detectable brain damage for 30 + minutes. Keep in mind some of the following: CPR, even CPR performed correctly often results in death. Sometimes the last beat of the heart is just that, the last beat. This does not mean you should not try to perform CPR; just that one should not blame one&#8217;s self, if the out come is not successful. The main cause of cardiac arrest in infants is respiratory arrest. That is why with infants and children it is suggested to perform 1 minute of CPR before activating 911, if you are alone. In a mass casualty incident, individuals in cardiac arrest are usually placed in a priority 4 category - untreatable. Bottom line: Everyone should take a basic first aid and CPR class. Pete

I'm in agreement with pete. Although your idea is a good one, I'm afraid it probably wouldn't work very well. Unless the person trying to perform CPR really knows what they're doing (in which case they wont need the card), they would be much more help dialing 999 (or 911 if you're not on my side of the pond) as quickly as possible. Not only does this reduce the time before profesional help reaches the casualty, but (in the UK at least) the controller will normally give CPR instructions over the phone. It is far easier for someone to talk you throuh resus than it is to try and read it off a card. Chances of survival for a suspended casualty decrease by about 10% every minute. CPR helps, but unless the cause of the arrest is respiratory, CPR wont revive the person. You would probably be better off with a mobile phone on you so that your rescuer can call the emergency services without leaving you.

On a similar note, a card detailing any alergies to medications and underlying medical conditions you have would probably be very helpfull to the doctors and paramedics that treat you.

Chris

If you ever have to have an unfamiliar person giving somebody CPR the best thing you could have is this:

CPR Prompt® Rescue Aid
This is an actual device that walks you thru the CPR steps.

Now something that I learned working in the 911 system in NYC. You can save 1000 lives and no one will notice but that's ok it's my job. But loose one and you will hear about it for the rest of your career. Even if CPR is a simple by the numbers (or letters) task there is so many things that can go wrong. Lets say you passed out and person goes to check your pulse at the wrist (cartoid pulse) and comes up with no reading. No pulse, you should start CPR according to the card. Well cartoid pulse will only register if you are 75 and above. By starting compressions and ventilations you just succesfully interupted heart rythm and blood flow. Now lets say you just felt down the stairs and this time you really have no pulse. Person whips out a CPR card goes to the first point which says: "...establish the airway using head tilt chin lift". They go for it and agrivate possible spine injury even more. I don't even want to go into trauma scenarios. In the end even if the person knows CPR but basic body substance insulation tools are not there (gloves, masks) the chance is, that person will not do it for you. Loved one or a friend yes, but total stranger no.

Personally I'm a strong supporter of the mandatory CPR course when you get your DL.

Matt

I think one failing of CPR training is not pointing out that the victim may likely die. I have heard that about one-third of all attempts are successful. True, a lot of things can go wrong - fractures of the sternum are common, even by EMT level practitioners - but the alternatve is even worse. A really alert aider when faced with the likelihood of spinal injury, will use the jaw thrust maneuver to open the airway.

Myself, I have a perfect record - two for two. In both cases, the victims were dead by the time I had the oportunity to administer my healing arts.

All of the various gizmos mentioned in this thread may be of some use, but I think there is no substitute for regular training by as many people as possible - an opinion that gains in strength as I grow older and older.

Just a quick point. The pulse at the wrist is the radial pulse, the carotid pulse is in the neck.

I don't know what the current prococol is in the US, but here in Britain lay responders are being taught to use skin colour as the main indicator of circulation rather than taking a pulse.

IIRC 2/3 of all attempted resus by non medical profesionals is either friend or family, so it would be a good idea to make sure your family and close friends take a CPR course.

Rather than CPR when you do your DL, I'd like to see it taught in schools. I'm going to do just this with a collegue of mine in a coulpe of days. Young children tend to pick up the skills alot quicker than adults and are more likely to call 999 (or 911) quicker than an adult.

Hikerdon raises a very good point, a person in cardiac arrest (most adult arrests are cardiac in nature) needs defibrilation within no more than 8 minutes. CPR may raise this to about 12 minutes, if you're lucky. So unless you have quick access to a defib, CPR will not revive the person.

If it is respiratory arrest however, the chances of CPR reviving the person are much better. In drowning victims, casualties with a head injury or young children, CPR may well revive the person.
The same is true for hypothermia, but the casualty must be SLOWLY returned to the normal temperature with constant CPR being performed.

Chris

It's all true what you are saying. I'm doing CPR at least twice a week (that's a good week). There is no substitute for training and experience. Little gizmos won't tell you all the subpoints of ABCs. The point that originally was made was that person wanted to have an instruction for others just in case they passed out and were in the need of CPR.

Once in the thousand cases maybe a person will save somebody while performing a cpr out of a cheat sheet. But I bet you they would cause much more harm for the rest of the people they would help. And I'm not talking about breaking sterum or cracking ribs. Did you ever try to do and maintain by yourself a jaw thrust whyle continuing ventilations? It's hard as hell and imagine somebody without a training trying that from the pic alone for the first time under pressure.

I know this has probibly be said, but im kinda too lazy to read through all the post. Anyway, my suggestion is go take a CPR course. This is for a few reasons. The main one being you get trained in first aid, CPR, and now I recently got trained in AED use too. This means you are taught the most up to date CPR instructions, you get a book (or a few) on first aid/CPR, and you get a card saying you are certified. Some courses even give out CPR mask and have certification cards with basic CPR instructions on them. Another thing is if you were to perform CPR and acccedentally hurt someone if you arn't certified the "Good Samaritan" law may not apply to you in some places. This means you could be sued. Atleast with certification you have a better reason for trying. Definately look into taking a course. Im certified by the American Heart Association for AED (defib) use, and by the American Safety and Health Institute for CPR/First Aid. It is well worth it. <img src="images/graemlins/smile.gif" alt="" />